摘要
目的 探讨非小细胞肺癌神经内分泌 (NSCLC NE)分化与患者手术后生存关系。方法 收集1997年 4月至 1999年 4月 98例肺癌手术切除病理标本 ,采用免疫组化标记特异性烯醇化酶 (NSE)及突触素(SY) ,并按强弱区分为“ +、 、 ”。对同一手术病例标本采用电镜观察特异性NE颗粒。术后病例随访 3 6月 ,最长 60月。采用Cox多因素风险模型分析NSCLC NE分化与患者术后生存的关系。结果 91例为非小细胞肺癌。非小细胞肺癌NE阳性表达率为 63 .7% ( 5 8/91) ,其中NSE阳性表达 5 4例 ( 5 9.3 % ) ,SY阳性表达 2 2例 ( 2 4.1% ) ,电镜观察NE特异性颗粒 3 0例 ( 3 3 .0 % )。结合免疫组化和电镜观察 ,NSCLC NE分化 44例 ( 4 8.4% )。Cox模型多因素分析结果表明NSCLC NE分化者术后生存时间明显缩短 (P =0 .0 48)。术后生存与肺癌细胞分化程度 (P =0 .0 0 6)、病理分期 (P =0 .0 0 1)、NE表达强弱 (P =0 .0 5 4)有密切关系。结论 NSCLC NE分化与肿瘤细胞分化和患者术后生存有关。采用NE标志物标记肿瘤 ,并观察其强弱改变 ,对术后评估具有较重要的参考意义 ,可作为临床判断患者预后指标之一。
Objective To observe the relationship between non-small cell lung cancer with neuroendocrine differentiation (NSCLC-NE) and patients’ postoperative survival. Methods During April 1997 to April 1999, ninety-eight patients with lung cancer who were surgical treated were enrolled in this study. The tumor specimens were stained by NE markers: neuron specific enolase (NSE) and synaptophysin (SY). The NE marker reactions were divided as +, and scale groups. The same specimens were also examined by electron microscope for the specific neuroendocrine granule. All enrolled patients were followed up to 36 months, and the maximum follow-up time was 60 months. The Cox proportional hazard model multivariate analysis was applied to observe the relationship between the NSCLC-NE and the patients’ postoperative survival. Results Ninety-one cases were diagnosed as NSCLC. In these patients, 63.7% (58/91) were positive for NE stain. Among them, 59.3% (54/91) were NSE-positive, and 24.1%(22/91) were SY-positive. The specific NE granules were found by the electron microscope examination in 33.0%(30/91). Combination of NE marker stain reaction and electronic microscope examination results, 48.4% (44/91) were considered as NSCLC-NE. The Cox proportional hazard model multivariate analysis showed that the NSCLC-NE patients’ survival was significantly reduced (P=0.048). The following factors were related to NSCLC-NE patients’ survival: lung cancer cell differentiation (P=0.006), stages of the cancer (P=0.001), and the NE markers reaction (P=0.054). Conclusion NSCLC-NE is significantly related to the cancer cell differentiation and the patients’ postoperative survival. The NE markers should be applied clinically as one of prognostic factors to evaluate the postoperative survival for NSCLC patients.
出处
《中国肺癌杂志》
CAS
2004年第2期146-150,共5页
Chinese Journal of Lung Cancer
