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目的探讨血管内皮生长因子C(vascular endothelial growth factor-C,VEGF-C)表达、细胞角蛋白19(cytokeratin 19,CK19)检测在Ⅰ期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者生存分析中的意义。方法纳入青岛大学医学院附属医院2004年1月至2005年6月由同一组医师完成的NSCLC患者269例,均行标准肺叶切除+区域淋巴结清扫术,全部患者临床资料和随访资料完整,病理标本保留完善,手术前、后均未行放疗和化疗等辅助治疗。应用免疫组织化学链霉菌抗生物素蛋白-过氧化物酶连结法(S-P)检测癌组织标本中VEGF-C表达,以CK19标记检测肺门和纵隔淋巴结微转移的情况,结合患者临床资料、病理结果及随访数据进行统计学分析。结果269例患者的性别(Hc=1.722,P=0.084)、年龄(Hc=0.914,P=0.360)、吸烟情况(Hc=2.440,P=0.295)、病理类型(Hc=5.668,P=0.058)和肿瘤直径(Hc=0.165,P=0.920)间VEGF-C表达差异无统计学意义,不同病理分化程度间VEGF-C表达差异有统计学意义(Hc=29.178,P=0.000);患者CK19检测在性别(χ2=0.000,P=0.999)、年龄(χ2=0.005,P=0.999)、吸烟情况(χ2=2.294,P=0.317)、病理类型(χ2=0.573,P=0.289)、病理分化程度(χ2=2.927,P=0.231)和肿瘤大小(χ2=0.006,P=0.999)间差异无统计学意义;VEGF-C表达强度不同时5年生存率差异有统计学意义(χ2=37.318,P=0.000);CK19阳性和阴性表达5年生存率差异有统计学意义(χ2=39.987,P=0.000);VEGF-C表达与CK19阳性率之间差异有统计学意义(χ2=25.954,P=0.000)。结论 VEGF-C表达、CK19结果与Ⅰ期NSCLC患者术后5年生存率关系密切,VEGF-C、CK19检测有助于判断患者预后,并指导患者手术后辅助治疗,具有较大的临床意义。
Objective To investigate the expression of vascular endothelial growth factor-C (VEGF-C) and cytokeratin 19 (CK19) in stage Ⅰ non-small cell lung cancer (NSCLC) Meaning in Survival Analysis. Methods Totally 269 NSCLC patients completed from January 2004 to June 2005 in Affiliated Hospital of Medical College of Qingdao University were performed standard lobectomy and regional lymph node dissection. The clinical data and follow-up data of all the patients were complete. The pathological specimens Preserved well, before and after surgery were not radiotherapy and chemotherapy and other adjuvant therapy. Immunohistochemical streptavidin-peroxidase-linked assay (SP) was used to detect the expression of VEGF-C in the specimens of the cancer tissues. The micrometastases in the hilar and mediastinal lymph nodes were detected by CK19 markers. Combined with the clinical data, pathology Results and follow-up data for statistical analysis. Results There were 269 patients with Hc = 1.722, P = 0.084, Hc = 0.914, P = 0.360, Hc = 2.440, P = (Hc = 0.165, P = 0.920). There was no significant difference in the expression of VEGF-C between different pathological grades (Hc = 0.165, P = 0.920) There were significant differences in age (χ2 = 0.005, P = 0.999), smoking (χ2 = 2.294, P = 0.317), pathological type (χ2 = 0.573, P = 0.289) (χ2 = 2.927, P = 0.231) and tumor size (χ2 = 0.006, P = 0.999). There was no significant difference in the 5-year survival rates when the expression of VEGF-C was different (χ2 = 37.318, P = 0.000). The 5-year survival rate of positive and negative expression of CK19 was significantly different (χ2 = 39.987, P = 0.000). There was significant difference between positive expression of VEGF-C and CK19 (χ2 = 25.954, P = 0.000). Conclusion The expression of VEGF-C and CK19 are closely related to the 5-year survival rate of patients with stage Ⅰ NSCLC. The detection of VEGF-C and CK19 is helpful to judge the prognosis of patients and guide the patients to postoperative adjuvant therapy, which has great clinical significance.