论文部分内容阅读
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-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36例,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%(58/91),其中NSE阳性表达54例(59.3%),SY阳性表达22例(24.1%),电镜观察NE特异性颗粒30例(33.0%)。结合免疫组化和电镜观察NSCLC-NE分化44例(48.4%)。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=0.048)。术后生存与肺癌细胞分化程度(P=0.006)、病理分期(P=0.001)、NE表达强弱(P=0.054)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标志特标记肿瘤,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 investigate the relationship between neuroendocrine (NSCLC-NE) differentiation and postoperative survival in patients with non-small cell lung cancer. Methods A total of 98 cases of lung cancer resected from April 1997 to April 1999 were collected for immunohistochemical staining of specific enolase (NSE) and synaptophysin (SY) and divided into “+, + +, +++ ”. Specimens of the same operation were observed by electron microscopy specific NE particles. Postoperative cases were followed up 36 cases, up to 60 months. Cox multivariate risk model was used to analyze the relationship between NSCLC-NE differentiation and postoperative survival. Results 91 cases of non-small cell lung cancer. The positive expression rate of NE in non-small cell lung cancer was 63.7% (58/91), of which NSE positive expression was 54 (59.3%), SY positive expression was 22 (24.1% . 44 cases (48.4%) were differentiated by NSCLC-NE immunohistochemistry and electron microscope. Cox model multivariate analysis showed that NSCLC-NE differentiation was significantly shorter survival time (P = 0.048). The postoperative survival was closely related to the differentiation of lung cancer cells (P = 0.006), pathological stage (P = 0.001), and NE expression (P = 0.054). Conclusion NSCLC-NE differentiation is related to tumor cell differentiation and postoperative survival. Using NE marker to mark the tumor and observe the change of its intensity has important reference value for postoperative evaluation, which can be used as one of the prognostic indicators in clinical judgment.