TN-C和Ki-67的表达与非小细胞肺癌临床病理特征的相关性

目的 探讨TN-C和Ki-67蛋白在非小细胞肺癌组织中的表达及其与非小细胞肺癌临床特征的相关性.方法 选择459例非小细胞肺癌患者的肿瘤组织样本,免疫组化检测组织中TN-C和Ki-67的表达,计算其阳性率,并进一步分析二者的表达与非小细胞肺癌临床病理特征的相关性.结果 (1)TN-C在不同性别、年龄、组织学类型、分化程...     

EGFR基因突变与非小细胞肺癌临床病理特征的关系

目的 研究临床病理特征及相关实验室检测指标与非小细胞肺癌患者外科手术治疗预后的关系.方法手术切除的非小细胞肺癌患者标本一共190例,采用实时荧光PCR法,检测EGFR 基因第 18、19、20 和 21 号外显子的突变情况.分析EGFR基因突变与其临床病理关系、EGFR基因突变丰度和临床特征的关系.结果 EGFR基因突变的影响因素包括:性别、吸烟史、病理分型,高危因素包括:女性、吸烟者、腺癌.190例 NSCLC 患者肿瘤组织中,成功检测出90例存在 EGFR 基因突变,EGFR 突变丰度与性别(P=0.962)、吸烟史(P=0.809)无相关性;EGFR突变丰度与病理分型相关.和非腺癌对比,腺癌患者EGFR基因突变丰度明显更高,(x2=14.110,P=0.000).术前腺癌血清VEGF水平明显低于非腺癌组,P＜0.05;术后腺癌血清CD44v6明显高于非腺癌患者,P＜0.05;术后Ⅲ～Ⅳ期组血清VEGF、CD44v6水平明显高于Ⅰ～Ⅱ期患者,P＜0.05.结论 非小细胞肺癌EGFR基因突变的高危因素为吸烟者、女性、腺癌,与年龄、性别、肿瘤分期、吸烟史无明显相关性.     

AKT1表达与非小细胞肺癌临床病理特征及预后的关系

目的 探讨丝/苏氨酸蛋白激酶1(AKT1)表达与非小细胞肺癌(NSCLC)病理学特征及预后的关系.方法 选取经病理学检查证实的NSCLC患者90例,分别取其癌组织、癌旁组织为NSCLC组和癌旁组,采用免疫组化染色法检测2组标本中的AKT1蛋白表达水平,并分析AKT1蛋白与NSCLC患者TNM分期、淋巴结转移情况、肿瘤分...     

β-Catenin基因突变与非小细胞肺癌临床病理特征的关系

目的了解β-catenin基因外显子3在非小细胞肺癌组织中的突变及其与肿瘤病理分型、分化程度和淋巴结转移的关系.方法采用PCR-SSCP和DNA测序等方法对36例非小细胞肺癌术后标本,进行了β-catenin基因外显子3突变研究分析.结果在36例非小细胞肺癌组织标本中,19.44%(7/36)发生了β-catenin基因外显子3突变,其中4例突变位于密码子53.β-catenin基因外显子3的突变率与病理类型无关(P＞O.05);而与肿瘤的分化程度有相关性(P＜O.05);在有淋巴结转移的病例标本中,β-catenin基因外显子3的突变率明显高于无转移病例(P＜0.05).结论研究显示在非小细胞肺癌组织中的β-catenin基因外显子3有突变,并且在我国的突变率较国外的报道要高;β-catenin基因外显子3的突变与非小细胞肺癌淋巴结转移和肿瘤分化程度相关,提示β-catenin基因外显子3的突变是非小细胞肺癌患者的不良预后因素之一.     

内皮抑素在非小细胞肺癌中的表达及其与肺癌临床病理生理特征的关系

目的研究非小细胞肺癌组织中内皮抑素(endostatin)的表达及其与肺癌临床和病理生理特征的关系.方法采用免疫组化LSAB法检测46例肺癌组织、14例肺良性病变组织中endostatin的表达.结果①endostatin在肺癌组织中的表达水平(84.91%±7.65%)显著高于癌旁肺组织(63.70%±12.45%)和肺良性病变组织(40.29%±15.01%)(P＜0.01),癌旁肺组织亦显著高于肺良性病变肺组织(P＜0.01);②endostatin表达水平与肺癌原发肿瘤大小、有无远处转移、细胞分化程度、P-TNM分期均有密切关系(P＜0.05),而与肺癌原发部位、组织学类型、淋巴结转移状态、患者的性别、年龄、吸烟史等均无明显关系(P＞0.05);③多因素相关分析发现endostatin表达水平与原发肿瘤的大小、有无远处转移、P-TNM分期均呈负相关(P＜0.05),与细胞分化程度呈正相关(P＜0.01),与原发肿瘤部位、淋巴结转移状态、组织学类型、性别、年龄、吸烟史均无显著相关性.结论非小细胞肺癌组织中endostatin的表达水平可能是预测肿瘤恶性行为的有用指标.     

P53蛋白异常表达与非小细胞肺癌预后的关系

目的:为了解P53蛋白异常表达与非小细胞肺癌(NSCLC)预后的关系.方法:采用S-P免疫组织化学法,检测90例手术切除的NSCLC组织石蜡包埋标本.结果:53.3%(48/90)的标本显示P53蛋白向染色阳性.肺鳞癌和腺癌的阴性率分别为64.3%(36/56)和35%(12/34).统计学分析显示P53蛋白染色结果与病人年龄、性别及肿瘤分期无显著关系,但与肿瘤组织类型显著相关.P53蛋白染色阳性和阴性组病人中位生存月数分别是24个月和55个月.Kaplan-Meir图显示二组病人术后生存概率有明显差异.逐步回归多因素分析显示P53蛋白染色阳性与病人术后生存时间呈显著负相关.结论:P53蛋白异常表达是非小细胞肺癌预后不良的独立判断指标.     

循环血VEGF和MIC-1的表达与非小细胞肺癌临床病理特征及预后的关系分析

目的 探讨循环血VEGF和MIC-1的表达与非小细胞肺癌临床病理特征及预后的关系.方法 采用ELISA检测了100例健康体检者(对照组)及156例NSCLC患者的VEGF和MIC-1水平,分析其与患者临床病理特征及预后的关系.结果 研究组患者VEGF和MIC-1水平均显著高于对照组(P<0.05);研究组中不同病理类型...     

小细胞肺癌与非小细胞肺癌的CT特征对比研究

目的:比较小细胞肺癌与非小细胞癌的CT表现,探讨小细胞肺癌的CT特征.方法:140例患者经肺穿刺活检病理结果分为小细胞肺癌组(35例)与非小细胞肺癌组(105例),分析两组患者的CT特征.结果:两组CT表现特征对比,在病灶长径与支气管关系、有无毛刺、是否存在胸膜凹陷、是否累及纵隔大血管、是否存在远处转移、是否累及叶、段支气管方面差异有统计学意义(P＜0.01).结论:小细胞肺癌的CT表现特点为病灶与支气管长径多平行,周边光滑、毛刺少见,常累及叶支气管、甚至累及段支气管,胸膜凹陷少见,常累及纵隔大血管等.     

EXPRESSION OF P120ctn IN NON-SMALL-CELL LUNG CANCER: A CLINICOPATHOLOGICAL STUDY

The main characteristics of malignant tumors are invasive growth and the tendency to metastasis. In the process of invasive growth, one of the crucial steps is the detachment of intercellular junctions of tumor cells. Various cell adhesion molecules (CAMs) play an important role in this process. Among the most studied CAMs are the integrins, the selectins, the immunoglobin superfamily, and the cadherins. The cadherins, which are calcium dependent homotypic glycoproteins, form dimeric zipper…     

Erlotinib in advanced non-small-cell lung cancer after gefitinib failure

Purpose  To evaluate the efficacy and safety of erlotinib in advanced non-small-cell lung cancer after failure of gefitinib treatment. Patients and methods  Patients with advanced or metastatic NSCLC, who had progressed after gefitinib treatment, were included in this study; patients received erlotinib 150 mg/day until disease progression or intolerable toxicity. Results  Twenty-one patients were included in this study. Among them, 14 (66.7%) were male and 7 (33.3%) were female; median age was 63 years; 10 (47.6%) patients were smokers; 9 (42.9%)patients had squamous cell carcinoma subtype; 8 (38.1%) patients had adenocarcinoma subtype and 4 (19%) patients had the other NSCLC subtype. Out of 21 patients, 2 (9.5%) had PR and 4 (19.0%) had SD, giving an overall response rate of 9.5% and a disease control rate of 28.5%. The median TTP were 55 days, the median OS were 135 days. Two patients with PR to erlotinib treatment were female never smokers with adenocarcinoma histology and both had partial response to prior gefitinib treatment. Three of four patients with a SD to erlotinib treatment also had SD from prior gefitinib therapy. Smoking history, histology and response to erlotinib were significantly correlated with survival. The most common toxic effects were skin rash. Conclusions  Erlotinib may be an option for a more highly selected subset of patients, especially those who had already benefited from prior gefitinib treatment.     

吉非替尼单药治疗晚期非小细胞肺癌

目的观察吉非替尼单药治疗晚期非小细胞肺癌（NSCLC）的疗效和不良反应。方法对50例晚期NSCLC患者给予吉非替尼250mg／d口服治疗,观察疗效和不良反应,采用欧洲癌症研究和治疗组织生活质量调查核心问卷QLQ-C30和简明乏力量表（BFI）对患者的生活质量及临床症状的改善进行评价,观察疾病进展时间（TTP）和中位生存时间（MST）。结果50例晚期NSCLC患者中,无完全缓解者,部分缓解（PR）8例（16．0％）,临床获益率为60．0％,临床获益率与性别、病理类型及吸烟史有关。到随访截止日期,50例患者中,20例（40．0％）存活,其MST为13个月;30例死亡患者TTP为5个月,MST为6个月。PR患者MST为9个月。综合生活质量改善率为58．0％,乏力症状缓解率为52．6％,出现症状缓解的中位时间为15d。不良反应主要为Ⅰ、Ⅱ度皮疹和腹泻,对症处理后可缓解。3例既往因放疗而引起放射性肺炎的患者中,2例放射性肺炎加重。结论吉非替尼有明显抗肿瘤作用,能明显提高晚期NSCLC患者的生活质量,改善临床症状,不良反应可以耐受。     

乳腺与肺双原发性癌的临床病理特征分析

目的:探讨乳腺癌合并原发性肺癌患者的临床病理特征及同时手术的安全性。方法:回顾性收集1999 年1月至2017年12月中国医学科学院肿瘤医院收治的乳腺癌合并肺癌患者共计94例,经病例筛选后共71例纳入本研究,对纳入研究的双原发性癌患者临床病理特点进行分析。结果:71例患者中,乳腺癌作为首发癌合并肺癌 63例,肺癌作为首发癌合并乳腺癌 8例,两组患者在乳腺肿瘤大小、淋巴结转移数目、临床分期、病理类型、ER表达、Ki-67指数、HER-2表达、手术方式及有无放化疗史方面的差异均无统计学意义（均P>0.05）,但乳腺癌首发组患者无进展生存期优于肺癌首发组（P<0.05）。在同时性双原发性癌 28 例中,6 例患者（21.4%）同时接受乳腺癌及肺癌手术,围手术期无并发症发生,术后病情平稳。以乳腺癌作为首发癌的41例异时性双原发性癌中,中位间隔为57.3个月,肺结节平均观察时间为10个月。肺癌临床分期Ⅰ期以下占82.9%,病理类型中93%为腺癌。发现肺结节的早晚与乳腺癌术后复查及随访有关。结论:乳腺癌首发的双原发性癌患者预后较好;同时手术治疗乳腺癌及肺癌是安全可行的;在异时性双原发性癌中,肺癌一般是在乳腺癌术后 5 年内发现的,乳腺癌术后规律及时的随访有助于肺癌早期发现。     

Docetaxel-induced interstitial pneumonitis following non-small-cell lung cancer treatment

Interstitial pneumonitis has been described infrequently following administration of docetaxel, used alone or in combination with other chemotherapeutic agents or concurrent irradiation, for non-small-cell lung cancer (NSCLC). This toxicity is of special relevance in NSCLC, as clinical severity and differential diagnosis may be especially challenging. It seems to be due to type I and type IV hypersensitivity reactions to the drug. Clinical and radiographic features are nonspecific and diagnosis is made by exclusion. The rate of grade III-IV docetaxel-induced pneumonitis, ranging from 7 to 47%, depends on several factors, including total dose, chemotherapy schedule and especially concomitant docetaxel treatment with gemcitabine and radiotherapy. Although the usual outcome is cure, it sometimes eventually progresses to pulmonary fibrosis despite steroid treatment. This toxicity must be taken into account when planning treatment strategies for NSCLC in order to reduce its rate and to achieve prompt diagnosis and treatment.     

长春瑞滨联合卡铂治疗老年晚期非小细胞肺癌

目的：观察长春瑞滨(诺维本，NVB)联合卡铂化疗方案治疗老年晚期非小细胞肺癌患的临床疗效及不良反应。方法：对住院治疗的25例老年晚期非小细胞肺癌患采用NVB联合卡铂化疗方案，NVB25mg／m^2第1、8天，卡铂350mg／m^2第1天。每4周重复，至少治疗两周期，按标准评价疗效和毒副反应。结果：可评价患25例，有效率为48％，中位生存期7个月，1年生存率为32％。主要毒性反应为骨髓抑制、消化道反应及静脉炎，多数为Ⅰ～Ⅲ度反应。结论：NVB联合卡铂方案治疗老年晚期非小细胞肺癌临床疗效较好，毒性反应可以耐受。     

Maintenance chemotherapy for non-small-cell lung cancer

Currently, platinum-based combination chemotherapy is the standard first-line chemotherapy for non-small-cell lung cancer (NSCLC). Historically, platinum-based chemotherapy has been recommended for up to six cycles even for responders, and second-line chemotherapy has been considered when disease progression is confirmed. In spite of extensive investigations into maintenance chemotherapy, no positive data have been obtained; however, the results of recent clinical trials suggest both the safety and efficacy of maintenance chemotherapy in patients with NSCLC, although it is still controversial. In this review, we summarize the major clinical trials of maintenance chemotherapy in patients with NSCLC, and discuss its clinical validity and present future perspectives.     

Carboplatin and vinorelbine in advanced non-small-cell lung cancer

 A total of 32 patients with advanced non-small-cell lung cancer were treated with carboplatin (350 mg/m², day 1) and vinorelbine (days 1 and 8) every 28 days. A response rate of 28% (95% confidence limits 12.5 – 43.7%) was observed. The activity of this combination was demonstrated in an outpatient setting with acceptable toxicity. Received: 6 July 1995 / Accepted: 19 October 1995     

Carcinomatous meningitis from non-small-cell lung cancer responding to gefitinib

The prognosis for carcinomatous meningitis remains poor, and focal neurological dysfunctions usually do not improve despite the available treatment options. We report a case of carcinomatous meningitis from non-small-cell lung cancer treated with gefitinib, which brought about a sustained clinical response. A 40-year-old Japanese man was diagnosed with adenocarcinoma in the right lower lobe of the lung, and with multiple pulmonary and brain metastases. Six courses of carboplatin and paclitaxel chemotherapy and gamma-knife radiosurgery induced a near complete response in all lesions. However, 2 months later, cauda equina syndrome and left oculomotor paralysis from carcinomatous meningitis developed rapidly. Magnetic resonance imaging of the brain and spinal cord revealed the enhancement of leptomeningeal disseminations. The patient was treated with 250 mg/day gefitinib. All his neurological symptomatology disappeared within 2 weeks. The shrinkage of the leptomeningeal disseminations was confirmed by follow-up magnetic resonance imaging. The patient is currently doing well and is able to work. Cancer relapse was not observed at 4 months after the initiation of gefitinib. Although the survival benefit is controversial, gefitinib may have a role in the treatment of carcinomatous meningitis from non-small-cell lung cancer to improve neurological dysfunctions.