Ⅰ期、Ⅱ期非小细胞肺癌中血管和淋巴管浸润与预后的关系
The Relationship of Blood Vessel and Lymphatic Vessel invasion to Prognosis in Stage Ⅰ、Ⅱ Resected Nonsmall Cell Lung Cancer
-
摘要: 为评价Ⅰ、Ⅱ期非小细胞肺癌(NSCLC)中血管浸润(BVI)和淋巴管浸润(LVI)的预后意义,随访76例Ⅰ、Ⅱ期NSCLC病人,HE切片中组织学观察各例NSCLC中的BVI和LVI,Pearsonx2检验分析组间差异,Kaplan－Meier乘积限法和Cox比例风险模型用于生存分析。病人平均年龄56.0岁±8.2岁,中位随访时间为51个月,3年、5年总体生存率分别为68％和64％;BVI(＋)占28％,LVI(＋)占0.7％,BVI(＋)/或LVI(十)占34％;单变量生存分析显示:BVI而非LVI与生存差显著相关(x2=8.66,p=0.003);Cox回归多变量分析显示:脉管浸润(p=0.003)和淋巴结状况(p=0.01)是影响总体生存的独立预后因素。本研究提示:脉管浸润是评价Ⅰ、Ⅱ期NSCLC病人预后重要的病理因素。Abstract: In order to assess the prognostic value of blood vessel and lymphatic vessel invasion(BVI and LVI) in stage Ⅰ、Ⅱ resected nonsmall cell lung cancer.76 resected patientsfrom stage Ⅰ and Ⅱ NSCLC were followed.BVI and LVI were evaluated by light microscope in hematoxylin stain slides.Association among variables were tested by the Pearson chi-square test.Sue vival were analyzed by kaplan-Meier product-limit methodand the multivariable Cox model.The pattens' mean age was 56±8.2 years.Medianfollow-up was 5l months.Overall 3-year survival was 68% and overall 5-year sruvivalwas 64%.BVlwas present in 28% of NSCLC cases and LVI in 0.70%.BVI(＋)/or LVI(＋) was present in 34% of NSCLC.In univariate analysis, BVI ut not LVI was associated with poor survival (x2= 8.66, p=0.003).Cox regression multivariate analysisshowed vessel invasion(p=0.003) and lymph node status (p=0.01) were independentpredictors for poor overall survival.Our study suggested that vessel invasion was important pathological factor in evaluating prognosis of stage Ⅰand Ⅱ NSCLC.
-
Key words:
- non-small cell lung cancer /
- blood vessel invasion /
- lymphatic vessel /
- prognosis
-
-
[1] Flehingger BJ,Kimmel M, Melamed MR, et al. The effeet of surgical treatment on survival from early lung cancer: Implications for screening. Chest, 1992,101:1013 [2] Macchiarini P, Fontanini G, Hardin MJ,et al. Blood vesset invasion by tumor cells predicts recurrence in complete1y resected TINOM0 non-small cell lung cancer. J. Thorac. Cardiovasc. Surg.1993,106:80～89 [3] Ichionse Y,Yano T, Yokoyama H, et al. The correlation between tumor size and lymphatic vessel invasion in resected peripheral stage I non-small cell lung cancer. A potential risk of limited resection. J Thorac Cardiovasc Surg, 1994, 108:684～686 [4] Takise A, Kadama T. Shimosato Y, et al. Histopatholgtc prognostic factors in adenocarcinomas of the peripheral lung less than 2cm in diameter. Cancer, 1988, 61:2083～2088 [5] Fujisawa T, Yamaguchi Y, Saitoh Y, et al. Blood and lymphatic with primary resected non-small cell call carcinoma of the with intrapulmonary metastases. Cancer, 1995,76:2464～2470 [6] Shields TW Prognostic significance of parenchymal tyrn-phatic vessel and blood vessel invasion in carcinoma of the lung. Surg. Gynecol. ()bstet,1983,157:185～190 [7] Roberts TE Hasleton PS, Musgrove C,et al,Vascular in-vasion in non-small cell lung carcinoma. J Clin Pathol, 1992,45:591～593 [8] Brechot JM, Chevret S, Charpentier MC, et al. Blood vessel and lymphatic vessel invasin in resected nonsmall cell lung carcinoma. Cancer 1996, 78:2111～2118 [9] Lee AKC, Ire Lellis RA, Silverman Ml,et al. Prognostic siginificance of peritumoral lynphatic and blood vessel invasion in node-negative carcinoma of the breast. J Clin Oncol, 1990, 8:1457～1465
计量
- 文章访问数: 1250
- HTML全文浏览量: 19
- PDF下载量: 330
下载:
