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
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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.
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Key words:
- non-small cell lung cancer /
- blood vessel invasion /
- lymphatic vessel /
- prognosis
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