摘要
目的探讨肺腺癌中微乳头结构对肿瘤侵袭行为及其对预后的影响。方法选择具有完整临床病理及随访资料结果的肺腺癌91例,将病例分成微乳头结构阳性组(41例)和阴性组(50例)。阳性组按照该成分占肿瘤的多少又分成微乳头结构+(占肿瘤的1%～10%),++(占肿瘤的11%～30%),+++(超过肿瘤的30%)。结果总的5年生存率是64.8%。临床分期5年生存率分别为Ⅰ期88.9%、Ⅱ期46.2%、Ⅲ期23.8%。不同临床分期病例间的生存率差异有统计学意义(P=0.000)。微乳头结构含量多少与临床分期、肿瘤大小和5年生存率无关,P值分别是0.065、0.358、0.206。而微乳头结构阳性组和阴性组5年生存率分别是:41.5%和84.0%,P=0.000,且淋巴结转移率前者(65.9%)明显高于后者(20.0%),P=0.000。有无微乳头结构与临床分期和肿瘤大小有关,P值均为0.000,即分期越晚,肿瘤越大,出现此结构的几率越高。而有无微乳头结构与性别、吸烟史无关。同一临床分期中阳性组与阴性组5年生存率分别是:Ⅰ期:78.6%、92.6%(P=0.1548);Ⅱ期:30.0%,100%(P=0.0598);Ⅲ期:17.7%,28.6%(P=0.4045),但差异无统计学意义。结论肺腺癌中微乳头结构成分提示肿瘤高侵袭转移行为,是影响预后的重要因素,该病理形态的出现应提醒临床采取积极治疗措施并密切随访。
Objective To evaluate the prognostic significance of micropapillary pattern （MPP） in adenocareinoma of lung. Methods Ninety-one consecutively excised cases of pulmonary adenocareinoma, including follow-up data, were retrospectively studied. These tumors were divided into 2 major groups： those with MPP and those without MPP. The former was further subdivided according to extent of the micropapillary component, as follows： MPP ＋ （constituting 1% to 10% of the tumor）, MPP ＋ ＋ （constituting 11% to 30% of the tumor） and MPP ＋ ＋ ＋ （constituting more than 30% of the tumor）. Results The overall 5-year survival rate was 64. 8%. The 5-year survival rates were 88. 9% for stage Ⅰ tumors, 46. 2% for stage Ⅱtumors, and 23. 8% for stage Ⅲ tumor respectively （P =0. 000）. The extent of micropapillary component showed no correlation with tumor stage, size and 5-year survival rate （ P = 0.065, 0.358 and 0.206, respectively）. On the other hand, the 5-year survival rate was 41.5% for patients in the MPP-positive group （ number = 41 ） and 84. 0% for patients in the MPP-negntive group （ number = 50）. The percentage of nodal metastasis in MPP-positive group was also higher than that in MPP-negative group （P = 0. 000 ）. In pulmonary adenocareinoma, this characteristic histology correlated with tumor stage and size, but not with patient＇s gender and smoking history. Within the same stage, the 5-year survival rates of MPP-positive and MPP-negative groups were as follows ： for stage Ⅰ, 78.6% versus 92. 6% （P= 0.1548）, for stage Ⅱ, 30. 0% versus 100% （P=0.0598）, and for stage Ⅲ, 17.7% versus 28. 6% （P = 0. 4045 ）. Condusions MPP in primary pulmonary adenocareinoma, even when only constituting a minor component, predicts an aggressive clinical behavior and is associated with poor prognosis. Although it may not be an independent prognostic factor, presence of this histologic pattern should alert elinicians for more active treaiment and closer foollow up.
出处
《中华病理学杂志》
CAS
CSCD
北大核心
2006年第3期151-154,共4页
Chinese Journal of Pathology
关键词
肺肿瘤
腺癌
预后
Lung neoplasms
Adcnocarcinma
Prognosis
