摘要
背景与目的:WHO对细支气管肺泡癌(bronchioloalveolar carcinoma,BAC)进行了严格定义,虽然它是肺腺癌的一个亚型,但研究显示新定义后的细支气管肺泡癌生物学特性好于其它类型肺腺癌。本研究探讨新定义后的细支气管肺泡癌和其它肺腺癌在复发转移特性的区别,及转移相关因子的表达情况。方法:采用免疫组织化学SP法对28例病理确诊的Ⅰ期细支气管肺泡癌和40例Ⅰ期其它肺腺癌标本进行上皮型钙粘附蛋白(E-Cadherin)、Ⅳ型胶原(CollagenⅣ)、血管内皮生长因子受体-2(vascular endothelial growth factor receptor-2,VEGFR-2)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)和组织基质金属蛋白酶抑制剂-1(tissue inhibitor of matrix metalloproteinase-1,TIMP-1)检测,并分析它们的表达与患者复发转移的关系。结果:Ⅰ期细支气管肺泡癌5年生存率为88.7%,其它肺腺癌为57.3%(P<0.05);胸内复发在细支气管肺泡癌和其它肺腺癌的比例为75.0%和33.3%,胸外转移的比例为25.0%和66.7%(P<0.05)。CollagenⅣ、E-Cadherin、TIMP-1在细支气管肺泡癌中的阳性率高于其它肺腺癌,分别是78.6%和42.5%、78.6%和40.0%、67.5%和42.9%(P<0.01);VEGFR-2在其它肺腺癌的阳性率高于细支气管肺泡癌(85.7%vs77.5%,P<0.05);MMP-9在两组间的表达差异无统计学意义(85.0%vs78.6%,P=0.494)。结论:Ⅰ期细支气管肺泡癌与其它肺腺癌相比具有更低的转移倾向,更易出现胸内复发,而其它肺腺癌易于发生远处转移。Ⅰ期细支气管肺泡癌预后好于其它肺腺癌。
BACKGROUND ＆ OBJECTIVE. The histological definition of bronchioloalveolar carcinoma （BAC） has been changed recently by the revised World Health Organization （WHO） classification, Although bronchioloalveolar carcinoma is a subtype of lung adenocarcinoma, its biological features are better than those of other lung adenocarcinomas, This study was to analyze differences in metastatic activity between bronchioloalveolar carcinoma and other lung adenocarcinomas, METHODS. The expression of E-Cadherin, Collagen Ⅳ, vascular endothelial growth factor receptor-2 （VEGFR-2）, matrix metalloproteinase-9 （MMP-9）, and tissue inhibitor of matrix metalloproteinase-1 （TIMP-1） in 28 specimens of stage Ⅰ bronchioloalveolar carcinoma confirmed pathologically and 40 specimens of other stage Ⅰ lung adenocarcinomas were detected by immunohistochemistry. Their correlations to tumor recurrence and metastasis were analyzed. RESULTS. The 5-year survival rate was significantly higher in ths patients with bronchioloalveolar carcinoma than in the patients with other lung adenocarcinomas （88,7% vs. 57,3%, P 〈 0.05）. The intrathoracic recurrence rate was significantly higher and the extrathoracic metastasis rate was significantly lower in the patients with bronchioloalveolar carcinoma than in the patients with other lung adenocarcinomas （75% vs, 33.3%, 25% vs. 66,7%, P 〈 0.05）. The positive rates of Collagen Ⅳ, E-Cadherin and TIMP- 1 were significantly higher in bronchioloalveolar carcinoma than in other lung adenocarcinomas （78,6% vs. 42,5%, 78.6% vs, 40.0%, 67.5% vs, 42,9%, all P 〈 0,01）, The positive rate of VEGFR-2 was significantly higher in other lung adenocarcinomas than in bronchioloalveolar carcinoma （85,7% vs, 77.5%, P 〈 0.05）. There was no significant difference in the positive rate of MMP-9 between bronchioloalveolar carcinoma and other lung adenocarcinomas （85.0% vs. 78.6%, P = 0.494）. CONCLUSION, As compared with other lung adenocarcinomas, stage Ⅰ bronchioloalveolar carcinoma is less aggressive in clinical behavior and likely to develop intrathoracic recurrence, with less extrathoracic metastases and better prognosis.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2007年第7期785-789,共5页
Chinese Journal of Cancer
关键词
肺肿瘤
腺癌
细支气管肺泡癌
复发
转移
免疫组化
Lung neoplasm
Adenocarcinoma
Bronchioloalveolar carcinoma
Recurrence
Metastasis
Immunohistochemistry
