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1.
目的:探讨早期宫颈癌淋巴脉管间隙浸润与其预后生存的关系。方法:回顾性分析2013年5月至2016年5月本院收治的经实验室检查确诊为早期宫颈的84例患者的临床资料。整理患者术后病理检查结果,分析影响早期宫颈癌淋巴脉管间隙浸润对患者预后的影响。结果:经非条件单因素Logistic回归模型分析得出:组织学分型、分化程度、淋巴结转移、宫颈间质浸润深度为影响早期宫颈癌阳性淋巴脉管间隙浸润患者预后生存的单因素(P<0.05);经非条件多因素Logistic回归模型进一步分析,得出:低度分化、有淋巴结转移、宫颈间质浸润深度≧1/2为影响早期宫颈癌阳性淋巴脉管间隙浸润患者预后生存的危险因素(P<0.05);阳性、阴性淋巴脉管间隙浸润组患者4年内总生存率分别为77.50%、93.18%,4年无疾病进展生存率分别为67.50%、86.36%,相比存在统计学差异(P<0.05)。结论:淋巴脉管间隙浸润是影响早期宫颈癌患者预后生存的重要因素之一;低度分化、有淋巴结转移、宫颈间质浸润深度≧1/2为影响早期宫颈癌阳性淋巴脉管间隙浸润患者预后生存的危险因素。  相似文献   

2.
There are currently no universally accepted indications and criteria for additional surgical resection of the colorectum after endoscopic resection of the submucosal invasive cancer. The purpose of the present study is to establish accurate indications and criteria for additional surgical resection of the colorectum, based on the prediction of lymph node metastasis, after endoscopic resection of the submucosal invasive cancer. We investigated 140 submucosal invasive colorectal cancers and analyzed the pathologic factors of lymph node metastasis. The tumors were evaluated for pathologic factors in the invasive area of the submucosal carcinoma and were compared between the cases with lymph node metastasis and those without lymph node metastasis. Lymph node metastasis was observed in 13 cases (9%). Univariate logistic regression analysis showed that the depth of invasion, cribriform-type structural atypia, absence of lymphoid infiltration, lymphatic permeation, and venous permeation were statistically significant as risk factors for lymph node metastasis. Multivariate logistic regression analysis showed that the important risk factors included, in decreasing order, lymphatic permeation, absence of lymphoid infiltration, cribriform-type structural atypia, venous permeation, and depth of invasion. Submucosal invasion of 2 mm or more, and/or, depth of lymphatic permeation of 2 mm or more are risk factors for lymph node metastasis. The pathologic criteria based on our results for additional colectomy enables greater accuracy selection of patients who will undergo further surgical treatment after endoscopic resection.  相似文献   

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This study examines the prognostic significance of pathologic factors in patients with primary locally advanced rectal cancer treated prospectively with preoperative radiotherapy. From 1992 to 1998, 104 patients with rectal cancer of grades T3 or T4 and any N underwent preoperative radiotherapy followed by surgical resection. Survival curves were estimated according to the Kaplan-Meier method. Correlation of outcome with clinicopathologic variables (pathologic tumor and lymph node staging, histology, radial resection margin [RRM], clearance, vessel involvement, and tumor regression grade [TRG], quantitated in 5 grades) was evaluated using the Cox proportional hazards model. None of the patients achieved a histologically confirmed complete pathologic response, but 79% of the patients showed partial tumor regression (TRG2-4) and 21% did not show any tumor regression (TRG5). Among the tumors, 22% were of a mucinous type. The RRM was free of tumor in 76% of the surgical specimens. The median clearance was 2 mm. Vascular invasion was present in 37 cases (36%). In the univariate analysis, lymph node metastases, absence of tumor regression, positive RRM, and vascular invasion were correlated with adverse overall survival and disease-free survival; absence of tumor regression, positive RRM, and clearance <2 mm were correlated with local recurrences; and advanced pT stage was correlated only with disease-free survival. However, in the multivariate analysis, only lymph node metastases and RRM were independent prognostic factors for overall survival and disease-free survival, and clearance <2 mm was an independent prognostic factor for local control. Pathologic parameters remain strong determinants of local recurrence and survival in locally advanced rectal cancer, treated preoperatively with hyperfractionated and accelerated radiotherapy. We show that patients with advanced pT, positive lymph nodes, vascular invasion, positive RRM, clearance <2 mm, or absence of tumor regression are known to have poor clinical outcome.  相似文献   

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目的探讨血清纤维蛋白原水平及白蛋白/球蛋白比值对直肠癌患者生存预后的影响。方法选取我科2010年1月至2013年1月收治的直肠癌患者120例,检测术前患者的血清FIB、AGR水平,根据血清FIB、AGR水平,分为FIB正常组(48例)和FIB高水平组(72例)、AGR正常组(45例)和AGR低水平组(75例);分析术前血清FIB、AGR与直肠癌患者的临床病理学特征关系,判断血清FIB、AGR对直肠癌患者生存预后的影响。结果患者检测术前血清FIB高水平组值6.53±1.28 g/L高于FIB正常组3.12±0.61 g/L,差异具有统计学意义(P<0.05);血清AGR低水平组值1.23±0.08低于AGR正常组值2.12±0.19,差异具有统计学意义(P<0.05)。血清FIB、AGR水平与直肠癌患者的BMI、肿瘤直径、TNM分期和淋巴结转移有关(P<0.05)。单因素分析显示:肿瘤直径>2cm、TNMⅢ期、淋巴结转移、FIB升高和AGR降低是影响直肠癌患者的危险因素(P<0.05);多因素分析显示:淋巴结转移、FIB升高和AGR降低是影响直肠癌患者生存预后的独立危险因素(P<0.05)。结论血清FIB、AGR值正常患者生存预后优于血清FIB升高、AGR降低患者;血清FIB水平升高、AGR水平降低可作为影响直肠癌患者生存率的的独立危险因素。  相似文献   

7.
Nasopharyngeal carcinoma (NPC) is a head and neck malignant tumor rare throughout most of the world but common in Southeast Asia, especially in Southern China, which is with characteristics of early cervical lymph node metastasis and high incidence rate of distant metastasis. Insulin receptor substrate 1 (IRS-1) is a signaling adapter protein that is encoded by the IRS-1 gene in humans, plays an important role in the development, progression, invasion and metastasis of tumors. The aim of the present study was to investigate the association between the expression of IRS-1 protein and clinicopathological characteristics in NPC by immunohistochemistry. The results showed that the expression level of IRS-1 was significant higher in NPC than that in the control nasopharyngeal epithelia (P = 0.042). The positive percentage of IRS-1 expression in NPC with lymph node metastasis was also significantly higher than those without lymph node metastasis (P = 0.008). Positive expression of IRS-1 was proved to be the independent predicted factor for lymph node metastasis of NPC (P = 0.025) regardless of age, gender, histological type and clinical stages by multivariate logistic regression analysis. In addition, results showed higher sensitivity and agreement rate of IRS-1 for predicting lymph node metastasis of NPC patients. Taken together, high expression of IRS-1 might be closely correlated with lymph node metastasis in NPC and positive expression of IRS-1 could be used as an independent biomarker for predicting lymph node metastasis of NPC.  相似文献   

8.
To investigate the expression of KIAA1199 in tumor tissue and its potential value as a prognostic indicator of survival in patients with colorectal cancer (CRC). The expression of KIAA1199 mRNA in CRC was characterized using real-time PCR and 20 pairs of fresh-frozen CRC tissues and corresponding non-cancerous tissues. KIAA1199 protein expression was confirmed using immunohistochemistry on a tissue microarray chip from 202 patients with CRC. Then, we correlated KIAA1199 protein expression to CRC conventional clinicopathological features and patient’s outcome. The expression of KIAA1199 mRNA and protein were up-regulated in CRC compared to normal tissues (P = 0.015 and P < 0.001, individually). KIAA1199 protein expression was related to tumor invasion depth (P = 0.013) and lymph node metastasis (P = 0.003). Kaplan-Meier survival and Cox regression analyses revealed that high KIAA1199 expression (P < 0.001) and serum carcinoembryonic antigen (CEA) level post operation (P = 0.005) were independent factors predicting poor prognosis of patients with CRC. We present evidence that high expression of KIAA1199 is associated with tumor invasion depth, TNM stage, and poor prognosis in CRC. Our findings suggest KIAA1199 could be used as a prognostic factor and novel therapeutic target for CRC.  相似文献   

9.
目的 探讨直肠癌组织微血管密度 (MVD)和血管内皮生成因子 (VEGF)表达与肿瘤浸润和转移的关系 .方法 应用CD31抗体和VEGF抗体 ,采用免疫组化S -P法对 14 1例手术切除的直肠癌患者进行血管标记和染色 ,并取 10例直肠正常组织对照 .结果 有淋巴转移组直肠癌MVD、VEGF表达强度与无淋巴结转移组、正常对照组间比较 ,均有显著性差异 (p<0 .0 1) ,且MVD与VEGF表达两者呈正相关 (r=0 .93) .结论 直肠癌组织内微血管密度和VEGF表达强度与直肠癌的浸润深度及淋巴结转移密切相关 ,两者均可考虑作为预测直肠癌发生转移的指标 .  相似文献   

10.
目的:探讨TWIST,HIF-1α和VEGF在人胃癌组织中的表达及与临床病理参数、预后的关系。方法:选择120例胃癌标本,应用SP法免疫组化检测TWIST、HIF-1α和VEGF在人胃癌组织中的表达,分析TWIST、HIF-1α和VEGF的表达与患者临床病理参数之间的关系。结果:胃癌组织及正常胃黏膜组织中均可检测到TWIST、HIF-1α和VEGF的表达,但胃癌组织中的表达水平均明显高于正常胃黏膜组织,表达差异有显著性(P<0.05)。TWIST的表达与浸润深度、肿瘤远处转移及淋巴结转移明显相关(P<0.05)。HIF-1α的表达与肿瘤的分化程度、浸润深度及淋巴结转移呈明显相关性(P<0.05)。VEGF的阳性表达与浸润深度、淋巴结转移及TNM分期有关(P<0.05)。TWIST和(或)HIF-1α阳性表达的患者其5年生存率明显低于其阴性表达的患者。结论:胃癌中TWIST、HIF-1α和VEGF的高表达与胃癌的生物学行为及预后密切相关,检测其表达对预测胃癌的转移及判断预后有一定价值。  相似文献   

11.
Adenocarcinoma of the stomach having invasion limited to the muscularis propria with or without lymph node metastasis, termed PM (proper muscle) gastric cancer by Japanese investigators, has a prognosis superior to that of carcinoma extending to the serosa and approaching that of early gastric cancer in Japan. To evaluate the occurrence and significance of PM gastric cancer in the United States, we analyzed 272 gastric carcinomas resected at our institution between 1964 and 1983. Forty-two PM cancers (15%) were identified. Improved 5-year survival rate was noted for PM cancer when compared with survival rate for 215 neoplasms exhibiting serosal invasion (29% versus 7%, P less than 0.001). In univariate analysis, a survival advantage was also associated with absence of lymph node metastasis, intestinal-type histopathology of the Lauren classification, the expanding pattern of the Ming classification, and polypoid or fungating gross configuration of tumor. In multivariate analysis, depth of tumor invasion remained significantly associated with improved 5-year survival rate independently of other variables, including lymph node metastasis. Using continuous survival curves, the prognostic significance of PM cancer prevailed throughout the 5-year postgastrectomy interval. Our data indicate that PM gastric cancer occurs in the United States and need not be considered "advanced" gastric carcinoma; depth of tumor invasion should be recognized as a nodal metastasis-independent prognosticator of gastric cancer survival.  相似文献   

12.
Because rectal neuroendocrine tumors (NETs) are usually small-sized despite of malignant potential, endoscopic resection techniques are recommended. It is unclear whether the lymphovascular invasion (LVI) in the endoscopic resected specimens of small rectal NETs should be indicated for completion surgery. We performed a systematic review and meta-analysis for the incidence of LVI in small rectal NETs (≤20 mm) treated by endoscopic resection and its prognostic impacts.We searched the relevant literature published before January 2019. A total of 21 publications including 1816 patients were enrolled.Overall prevalence of LVI in small rectal NETs was 21.8%. Immunohistochemical method significantly increased the detection rate of LVI up to 35.8% compared than H&E staining only (13.2%). Tumor size more than 5 mm was a risk factor for LVI in small rectal NET, whereas tumor grade did not influence the risk. The LVI in the endoscopic resected specimens was a risk factor for subsequent lymph node metastasis. Separately analyzed in detail, the vascular invasion had a stronger impact on lymph node metastasis than the lymphatic invasion. The prognosis of endoscopically treated rectal NET with LVI was excellent with only 0.3% of recurrence rate during the 5-year follow-up period.LVI is highly prevalent and a risk factor for lymph node metastasis in the small rectal NETs. Endoscopically treated small rectal NETs had excellent short-term prognoses despite of LVI. Immediate completion radical surgery is not absolutely necessary for the LVI-positive small rectal NETs. However, long-term follow-up is recommended for any delayed recurrence.  相似文献   

13.
CD147 is 1 of the molecules involved in regulating the expression of matrix metalloproteinases (MMPs). The goal of this study was to analyze the expression of CD147 in differentiated thyroid carcinoma (DTC) tissues as well as its association with the clinicopathologic features of DTC patients and its prognostic significance. During our research, CD147 expression in 156 patients who underwent operation for DTC [100 with papillary thyroid carcinoma (PTC) and 56 with follicular thyroid carcinoma (FTC)] were examined by immunostaining on paraffin-embedded tumor specimens. Then, the association of CD147 expression with clinicopathologic characteristics and patients' prognosis was analyzed. As a result, CD147 was expressed in cancerous lesions but not in normal tissues. Overall, 55 of 156 (35.26%) cases showed low CD147-positive expression, 52 of 156 (33.33%) showed intermediate CD147-positive expression, and 49 of 156 (31.41%) showed high CD147-positive expression. Positive CD147 staining was associated significantly with various clinicopathologic features, such as extrathyroidal invasion (P = 0.02), lymph node metastasis (P = 0.01), and depth of tumor invasion (P < 0.01). Patients with low CD147 expression showed better survival rates than those with intermediate and high expression (90.91% for low expression, 82.69% for intermediate expression, and 65.31% in high expression, respectively; P < 0.05 for analyses). Using Cox regression analysis of the 156 patients, high expression of CD147, extrathyroidal invasion, lymph node metastasis, and the pathologic grading of tumor invasion seemed to be independent prognostic indicators (P < 0.01, P = 0.02, P < 0.01, and P < 0.01, respectively). Therefore, we conclude that the expression of CD147 may be useful to predict the prognosis of DTC patients.  相似文献   

14.
目的 探讨肿瘤干细胞标志物含亮氨酸重复序列G-蛋白偶联受体5(1eucine-rich repeat-containing G protein coupled receptor 5,Lgr5)及乙醛脱氢酶1(aldehyde dehydro-genase 1,ALDH1)在卵巢癌中的表达与临床意义.方法 选取2006年5月至2010年1月住院并接受手术治疗的卵巢癌患者140例,选取同期本院因卵巢良性病变行肿物剥除或附件切除的40例患者作为对照,应用免疫组化(S-P)方法检测140例卵巢癌组织(卵巢癌组)、140例卵巢癌癌旁组织(癌旁组)、正常卵巢组织40例(正常组)中的Lgr5及ALDH1蛋白表达,分析其与卵巢癌患者临床病理指标的关系.结果 (1)Lgr5在正常卵巢组织、癌旁组织和卵巢癌中的阳性率(5.0% vs 18.3% vs 95.7%)差异具有统计学意义(P=0.001);ALDH1在正常卵巢组织、癌旁组织和卵巢癌中的阳性率(7.5% vs 15.7% vs 90.0%)差异具有统计学意义(P<0.05).(2)Lgr5表达与肿瘤分化程度、淋巴结转移及TNM分期有关(P<0.05).ALDH1表达与肿瘤分化程度、浸润深度、淋巴结转移及TNM分期有关(P<0.05).(3)Lgr5及ALDH1存在正相关性(r=0.3,P<0.05).(4)Lgr5高表达者(+++)和低表达者(+)~(++)5年总生存率分别为51.2%和29.2%(HR=11.637,95%CI:4.351~38.213;P=0.002);ALDH1高表达者(+++)和低表达者(+)~(++)5年总生存率分别为41.3%和35.3%(HR=10.143,95%CI:4.285~33.275;P=0.006)..多因素Cox回归分析显示,Lgr5蛋白(+++)表达(P=0.002)、ALDH1蛋白(+++)表达(P=0.006)、分化程度(P=0.036)、浸润深度(P=0.001)和远处转移(P=0.002)是影响胃癌患者预后的独立因素.结论 Lgr5及ALDH1的增强表达与卵巢癌侵袭性增强有密切关系,其表达可作为判断卵巢癌患者预后的指标.  相似文献   

15.

INTRODUCTION:

Evaluation of pre- and postoperative serum CEA levels together has seldom been assessed for the prognosis of colorectal cancer (CRC). OBJECTIVE: To concurrently evaluate pre- and postoperative CEA as factors of relapse and survival.

METHODS:

The study consisted of 114 patients who had undergone surgery from February 2002 to June 2006 for CRC. All patients were classified into four groups according to their pre- and postoperative CEA levels. Data obtained for clinicopathologic parameters, lymph node metastasis, stage, recurrence, and CEA levels were analyzed to determine their association with survival. Multivariate analysis by the Cox proportional hazard regression model was performed to identify the independent prognostic factors associated with survival.

RESULTS:

Postoperative serum CEA levels remained high in Group 3 (n = 32). Nineteen patients (59.3%) demonstrated a detectable cause for persistent high CEA levels, while the reasons for those in the other thirteen patients (40.6%) remained obscure. Abnormal preoperative CEA levels significantly correlated with the depth of tumor invasion, lymph node metastasis, TNM stage, and recurrence (p < 0.05). Abnormal postoperative CEA levels were significantly related to the depth of tumor invasion, TNM stage, and postoperative relapse (p<0.05). Patients in Group 3 demonstrated the worst survival rate. Abnormal postoperative CEA levels, lymph node metastasis, and location of the tumor were independent prognostic factors for survival.

CONCLUSION:

The survival of patients with high postoperative CEA levels due to unknown reasons may be extended if they are exhaustively tested with sensitive diagnostic methods and treated at an early stage.  相似文献   

16.
The gene TRIM23 (tripartite motif containing 23) is a member of the tripartite motif (TRIM) family whose expression putatively participates in many pathophysiological processes. Nonetheless, the role of TRIM23 in gastric cancer (GC) remains uncertain. Our study evaluated the expression of TRIM23 in GC tissues and cell lines, and investigated an association between TRIM23 and survival. In the present study, our results demonstrated that TRIM23 mRNA and protein were frequently over-expressed in GC cell lines and GC tissues. High level of TRIM23 protein correlated with tumor size, tumor-node-metastasis (TNM) stage, depth of invasion, lymph node metastasis (LNM), tumor differentiation, and nerve invasion. Compared with the low TRIM23 protein group, the high TRIM23 protein group was significantly associated with worse prognosis of GC patients. Consistently, the KM-plot database suggested that high TRIM23 mRNA expression was also linked to a poor prognosis in GC patients both in positive and negative subgroups of human epidermal growth factor receptor 2 (HER2). But in the HER2 positive subgroup, the advantages of the low TRIM23 expression on overall survival were much more statistically significant. The univariate analysis indicated that TRIM23 expression correlated with overall survival. The multivariate analysis showed that independent factors of prognosis in GC were lymph node metastasis, vascular invasion, and depth of invasion. In summary, TRIM23 may be associated with progression of GC, and may be considered a therapeutic target for GC patients.  相似文献   

17.
Visceral pleural invasion (VPI) is defined as penetration by cancer cells of the elastic layer of the pleura. The purpose of this retrospective study was to compare the effect of invasion of the inner elastic layer of the pleura on survival to that of invasion of the outer elastic layer. One hundred twenty-four pT1 size lung adenocarcinomas were examined for visceral pleural invasion, which was classified into three types: no pleural invasion (NPI), invasion of the inner elastic layer only (IEL), and invasion of both inner and outer elastic layers (OEL). The relationship between the types of VPI and the prognosis was analyzed by univariate and multivariate analyses. Seventy-three (59?%) cancers showed NPI, while 51 cancers showed invasion of the pleura [(IEL) in 26 (21?%), OEL in 25 (20?%)]. The 5-year survival was 81, 60, and 37?% for patients with NPI, IEL, and OEL, respectively. Survival was poorest in patients with OEL (P?<?0.01). Invasion of the outer elastic layer was also significantly associated with lymph node metastasis and frequent lymphatic involvement, micropapillary pattern, higher stromal invasion grade, and presence of small cluster invasion within tumors. Univariate analysis showed a significant relationship between invasion of the outer elastic layer and poor prognosis. However, multivariate analysis identified lymph node metastasis as the most significant predictor of poor prognosis. Analysis of invasion of the inner and outer visceral pleura is important; invasion of the outer elastic layer correlates with poor prognosis in pT1 size lung adenocarcinomas.  相似文献   

18.
目的分析中性粒细胞—淋巴细胞比(NLR)预测早期胃癌(EGC)淋巴结转移的临床价值,以期为EGC治疗方案的制订提供参考。方法回顾性分析在我院行胃癌根治术并经术后病理确诊为EGC的134例患者的临床资料,根据淋巴结是否转移分为阳性组和阴性组。收集EGC患者术前1周血液学指标并计算血小板—淋巴细胞比(PLR)和NLR;收集患者基本信息及术后病理信息,行单因素和多因素Logistic回归分析;通过受试者工作特征(ROC)曲线分析NLR预测EGC伴淋巴结转移阳性的诊断价值;分析术前NLR与患者一般资料及临床病理之间的相关性;Pearson相关性检验分析NLR与肿瘤大小的相关性;Kaplan-Meier(K-M)曲线及Log-rankχ2检验比较高NLR组和低NLR组患者术后生存状况。结果单因素分析结果显示,浸润深度、分化程度、肿瘤大小、PLR、NLR与淋巴结转移相关(P<0.05)。多因素Logistic回归分析结果显示,肿瘤大小≥2cm、浸润深度为黏膜下层、分化程度为低分化、NLR≥1.965是淋巴结转移的独立危险因素(P<0.05)。根据ROC曲线,NLR截断值为2.295,术前NLR预测淋巴结转移的灵敏性和特异性分别为82.6%和77.5%。根据截断值将所有患者分为低NLR组(NLR<2.295)90例和高NLR组(NLR≥2.295)44例,2组患者一般资料及临床病理相关因素分析结果显示,术前NLR与年龄、肿瘤大小、肿瘤大体类型显著相关(P<0.05)。术前NLR与肿瘤大小呈正相关(r=0.645,P<0.001)。术前高NLR组患者术后5年生存率明显低于低NLR组患者(P<0.05)。结论术前NLR对EGC患者发生淋巴结转移具有较高的预测价值,且对EGC患者预后的评估具有一定的临床参考价值。  相似文献   

19.
目的分析影响肝胆管细胞癌(ICC)患者手术预后的临床病理学因素。方法回顾性分析行根治性肝切除术的112例ICC患者的临床资料,统计患者术后1年、3年、5年累积生存率,通过单因素和多因素分析影响ICC患者预后的危险因素,并制作列线图模型。结果112例患者的中位生存期为27个月,术后1年、3年及5年的累积生存率分别为72.8%、40.7%、34.0%。单因素分析结果显示,癌胚抗原(CEA)、CA19-9、碱性磷酸酶(ALP)、HbsAg、胆管扩张、血管侵犯、局部侵犯、淋巴结转移、卫星结节、肿瘤分化程度、手术切除范围以及肿瘤TNM分期是影响ICC患者肝切除术预后的相关因素;多因素分析结果显示,HbsAg阴性、血管侵犯、卫星结节、肿瘤中低分化以及肿瘤TNM分期为ⅢA/ⅢB期是影响ICC患者预后的独立危险因素。根据多因素分析结果制作的列线图模型能较好地预测ICC患者的术后生存期。结论HbsAg阴性、血管侵犯、卫星结节、肿瘤中低分化以及肿瘤TNM分期为ⅢA/ⅢB期是影响ICC患者根治性肝切除术后生存期的独立危险因素。  相似文献   

20.
As the biologic behavior in lung tumors with neuroendocrine differentiation is highly dependent on cell death (apoptosis) and extracellular matrix invasion, Bcl2 and extracellular matrix density have been targeted as potentially useful tumor markers. In this study, we sought to validate the importance of Bcl2 and ECM density and to study the relationships of Bcl2 and ECM density with clinical factors and other tumor or stromal markers. We examined Bcl2 and several other markers in tumor tissues from 55 patients with surgically excised pulmonary typical carcinoid. We used histochemistry, immunohistochemistry, and morphometry to evaluate the amount of tumor staining for Bcl2 and ECM; the surrogate markers for aggressive potential for our study were tumor size and lymph node metastasis determined at diagnosis. Multivariate logistic model analysis demonstrated that after surgical excision control, tumor size was significantly related to nodal metastasis (P = 0.01), but quantitative staining of the tumor for Bcl2 and ECM added prognostic information and was as strongly prognostic as tumor size (P<0.01). Cutpoints at the median staining of 3.1% and 9.8 microm2 for Bcl2 and ECM, respectively, divided patients into two groups with distinctive risk for nodal metastasis. Those with Bcl2 > 3.1% and ECM <9.8 microm2 had high risk for nodal metastasis. We concluded that tumor staining for Bcl2 and ECM in resected PTC is strongly related to tumor size and nodal metastasis. Patients with > 3.1% and <9.8 microm2 staining in their tumors comprise a subset with a high hazard for nodal metastasis and may be an appropriate target for prospective studies of adjuvant chemotherapy after surgical resection.  相似文献   

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