TTF-1在Ⅰ期非小细胞肺癌中的表达与预后

目的 探讨甲状腺转录因子-1(TTF-1)在Ⅰ期非小细胞肺癌(NSCLC)中的表达、临床意义及其预后价值.方法 利用免疫组织化学技术检测129例Ⅰ期NSCLC组织中TTF-1的表达,分析其与临床因素及预后的关系.结果 TTF-1在Ⅰ期NSCLC中阳性表达率为64.3％,其中在肺腺癌中的阳性率高于其他亚组(x2=25.231,P＜0.001),低年龄组(＜60岁)高于高年龄组(≥60岁)(x2=4.581,P=0.032)、女性组高于男性组(x2 =4.900,P=0.027)及肿瘤的分化程度较高组(中分化、高分化)高于较低分化组(x2＝11.519,P=0.019).TTF-1阳性组和阴性组的中位无病生存期(DFS)及总生存期(OS)分别为38.9个月对27.8个月(P =0.023)及64.10个月对50.68个月(P=0.013).Cox回归分析显示,TTF-1阳性表达(P =0.005),肿瘤分化程度(P=0.044)是Ⅰ期非小细胞肺癌的独立预后因素.结论 TTF-1阳性表达患者预后较好.TTF-1阳性表达、肿瘤分化程度为Ⅰ期NSCLC预后独立的影响因素.     

抑癌基因P16在肺癌中的表达及意义

目的研究ｐ１６基因产物在人肺癌中的表达及其意义。方法用兔抗人ｐ１６多克隆抗体，以ＳＰ免疫组织化学方法检测肺癌组织中ｐ１６蛋白表达。结果ｐ１６在肺癌中表达阳性率为５８．５％（６２／１０６），在腺癌中的表达较鳞癌和小细胞癌高（Ｐ＜０．０５）。在鳞癌和腺癌中ｐ１６表达阳性率随着分化程度的降低而下降，高分化和低分化鳞癌之间ｐ１６阳性率有非常显著的差异（Ｐ＜０．０１）；鳞癌和腺癌中ｐ１６阳性率与有无淋巴结转移有密切关系（Ｐ＜０．０５）；与肺癌病理分期无明显关系。结论ｐ１６基因在不同类型肺癌的发生过程中作用不同，且与肺癌分化不良和有无淋巴结转移有密切关系。     

Claudin 3在肺鳞癌和腺癌的表达差异及预后探讨

目的:检测肺鳞癌和腺癌患者中Claudin 3的表达状况,并探讨其在肺鳞癌和腺癌的表达差异及其对预后的影响。方法:回顾性分析共160例行手术切除的肺鳞癌和腺癌患者的临床资料,免疫组化检测Claudin 3的表达情况,并将其表达与临床病理因素及预后进行分析。结果:单因素分析显示,性别、年龄、吸烟史、病理类型、术后辅助化疗及Claudin3表达等因素对患者生存率的影响无统计学意义(P0.05)。而T分期、N分期、TNM分期及是否复发转移等因素对患者生存率的影响有明显统计学意义(P0.05);Cox回归多因素分析显示:TNM分期(P=0.000)和复发转移(P=0.000)是非小细胞肺癌(NSCLC)独立的预后影响因素。鉴于不同病理亚型中Claudin3的表达差异,分层分析显示鳞癌与腺癌中Claudin3差异表达,且在鳞癌中阳性表达Claudin3的患者生存获益,而在腺癌中则是阴性表达Claudin 3的患者生存获益。结论:TNM分期(P=0.000)和复发转移(P=0.000)是NSCLC独立的预后影响因素。鳞癌与腺癌中Claudin3差异表达,且在鳞癌中阳性表达的患者生存获益,而在腺癌中则是阴性表达的患者生存获益。     

S100A4蛋白在人非小细胞肺癌间质中的表达及其临床意义

目的 探讨S100A4蛋白在人非小细胞肺癌(NSCLC)间质中的表达及其临床意义,以确定其与肿瘤的侵袭、转移及预后的关系.方法 130例NSCLC 患者手术切除的肺癌组织标本,应用免疫组织化学方法(SP法)检测S100A4蛋白在肺癌组织间质中的表达,分析其与预后的关系.结果 S100A4蛋白在NSCLC间质表达的总阳性率为72.3%(94/130),在鳞状细胞癌、腺癌、腺鳞癌和大细胞癌间质表达的阳性率分别为84.3%、59.6%、70.0%和75.0%.S100A4蛋白在NSCLC间质的阳性表达与淋巴结转移(χ2=18.91,P=0.000)、远处转移(χ2=5.51,P=0.019)及TNM分期(χ2=21.54,P=0.000)明显相关.间质S100A4蛋白表达阳性患者3年生存率为36.2%(34/94),明显低于表达阴性的患者[63.9%(23/36),P=0.003].Cox风险比例模型分析结果表明,年龄≤50岁(OR=1.866)、有淋巴结转移(OR=1.826)、有远处转移(OR=6.224)、肿瘤低、未分化(OR=1.793)、TNM分期Ⅲ～Ⅳ期(OR=2.573)和间质中S100A4蛋白表达阳性(OR=1.776)是影响肺癌患者预后的危险因素.结论 S100A4蛋白在NSCLC间质中的表达与肺癌的侵袭、转移、分期及预后密切相关,它有希望成为一种能预测肿瘤进展及指导临床治疗的标记物.     

黏蛋白4及胰岛素样生长因子-2对ⅢA～N2期非小细胞肺癌预后的影响

目的 观察黏蛋白4(MUC4)及胰岛素样生长因子-2(IGF-2)在ⅢA～ N2期非小细胞肺癌中的表达,探讨其对ⅢA～N2期肺癌患者预后的影响.方法 收集96例ⅢA～N2期肺癌患者的石蜡标本构建组织芯片,采用免疫组织化学方法检测MUC4、IGF-2在ⅢA～ N2期肺癌中的表达,并分析MUC4及IGF-2的表达与临床病理参数、淋巴结转移情况及患者预后的关系.结果 全组患者中,MUC4表达率高,为48.9％,在不同的淋巴结转移站数、个数,隆突下淋巴结转移,区域淋巴结转移及临床(病理)N2的癌组织中,表达差异有统计学意义(P＜0.05);MUC4高表达患者其中位生存期达到43个月,5年生存率为32.6％,明显优于低表达患者(P＜0.01),而IGF-2高表达患者中位生存期为19个月,5年生存率仅为15.1％,明显低于低表达组(P＜0.001),在COX多因素分析中,MUC4及IGF-2的表达水平均是影响ⅢA～ N2期肺癌患者预后的独立因素(P＜0.01),且MUC4与IGF-2的表达呈负相关(r=-0,226,P＜0.05).联合MUC4及IGF-2将全组患者行进一步亚组分析,其中MUC4+ + IGF-2-组的预后最好,其5年生存率高达49.7％,均优于其他3组(P＜0.01).结论 MUC4及IGF-2可作为影响ⅢA～N2期非小细胞肺癌预后的分子标志物,联合MUC4及IGF-2可将N2期非小细胞肺癌分为不同的亚组,其中MUC4+ + IGF-2-组的预后最好,可行积极的以手术为主的综合治疗.     

局限Ⅱ期小细胞肺癌的外科疗效分析

目的 探讨不同治疗手段和手术方式对局限Ⅱ期小细胞肺癌患者预后的影响.方法 回顾性分析2001年1月至2009年12月局限Ⅱ期小细胞肺癌患者82例临床病理资料.结果 全组患者中位生存期27.0个月,第1,3,5年生存率分别为62.1％,35.9％,21.0％.外科治疗患者中位生存期及5年生存率优于非外科治疗患者(P=0.000).行肺叶或全肺切除术患者中位生存期及5年生存率优于楔形切除术患者(P=0.048).行楔形切除术患者中位生存期及5年生存率优于非外科治疗患者(P =0.024).手术、化疗和放疗是影响局限Ⅱ期小细胞肺癌患者预后的独立因素.肺叶或全肺切除组局部复发率低于楔形切除组(P =0.030).远处转移率在肺叶或全肺切除组、楔形切除组和非外科治疗组呈逐渐上升趋势,通过两两比较,肺叶或全肺切除组低于非外科治疗组(P=0.021),肺叶或全肺切除组与楔形切除组、楔形切除组与非外科治疗组之间差异均无统计学意义(P＞0.05).结论 对于局限Ⅱ期小细胞肺癌患者,首选的初始治疗应推荐肺叶或全肺切除术,术后建议常规行辅助性化放疗.     

食管鳞癌G3BP和骨桥蛋白的表达及其对患者预后的影响

目的研究食管鳞癌组织中GTP酶激活蛋白SH3功能区结合蛋白(G3BP)和骨桥(OPN)蛋白的表达及其与食管鳞癌生物学行为之间的关系。方法采用免疫组织化学方法检测80例食管鳞癌组织中G3BP和OPN蛋白的表达情况,探讨它们与食管鳞癌的肿瘤大小、组织分化程度、TNM分期、淋巴结转移和预后的关系。结果(1)G3BP蛋白在食管鳞癌组织中的阳性表达率为71.3%,它在淋巴结转移组的阳性表达率高于无淋巴结转移组(Z=-2.283,P=0.022);而与肿瘤大小、组织分化程度、TNM分期无关(P>0.05);G3BP蛋白阳性表达组患者的术后生存时间较阴性表达组短,差异有统计学意义(P=0.000)。(2)OPN蛋白在食管鳞癌组织中的阳性表达率为100%,OPN蛋白的表达水平与组织分化程度(X~2=10.766,P=0.005)及淋巴结转移(Z=-2.289,P=0.022)有关,而与肿瘤大小和TNM分期无关(P>0.05);OPN蛋白的表达水平越高,患者术后生存时间越短(P=0.000)。(3)G3BP蛋白和OPN蛋白在食管鳞癌组织中的表达之间存在正相关性(r(?)=0.376,P=0.001)。结论食管鳞癌组织G3BP和OPN蛋白的表达与淋巴结转移情况及患者的预后有密切关系。     

胆囊癌组织中COX-2、VEGF的表达与血管形成的相关性及预后意义

目的研究原发性胆囊癌组织中VEGF(vascular endothelial growth factor,血管内皮生长因子)、COX-2的表达与血管形成的关系及预后意义。方法应用免疫组织化学SP法对64例胆囊癌组织COX-2、VEGF表达和MVC进行检测。结果 COX-2和VEGF阳性表达率分别为72％和 55％。64例胆囊癌MVC平均为(57±14)个／HP。MVC与胆囊癌分化程度、Nevin分期和淋巴结转移密切相关(t=2．948,t=5．102,t=7．329,P<0．05)。VEGF在中低分化型和有淋巴结转移胆囊癌中的表达显著高于高分化型和淋巴结未转移者(x2=5．752,x2=10．093,P<0．05)。COX-2在Nevin分期S4-S5和有淋巴结转移的胆囊癌中的表达显著高于分期为S1-S3和淋巴结未转移者(x2=6．886, x2=12．882,P<0．05)。COX-2和VEGF表达与MVC值之间具有显著相关性(r=0．268,x2=4．608, P<0．05,t=5．424,P<0．05)。COX-2、VEGF的表达与患者的预后有关(x2=8．276,x2=6．656, P<0．05),结论 COX-2、VEGF和MVC是反映胆囊癌生物学行为的重要参数。COX-2高表达与胆囊癌的血管生成密切相关,其可能机制之一是促进VEGF的表达。     

肺癌累及上腔静脉的外科治疗

目的分析探讨肺癌累及上腔静脉行手术切除的可行性及价值。方法回顾性分析1988年3月—2005年4月的31例肺癌累及上腔静脉手术治疗患者的临床资料,其中鳞癌17例、腺癌8例、小细胞未分化癌6例;N0．1期12例,N2期19例;T4期22例,T2．3期9例。采用上腔静脉切除人工血管置换（18例）,侧壁切除自体心包片修补（8例）、直接缝合（5例）的方法处理切除后的上腔静脉,统计围手术期并发症及长期生存率,分析生存及预后情况。结果18例上腔静脉置换者中,上腔静脉阻断者17例,阻断时间8～35min;13例上腔静脉部分切除修补者,9例阻断上腔静脉,阻断时间3～15min。无手术死亡,术后并发症发生率为48％（15／31）。术后随访28例,时间3～130个月,总的中位生存期为31个月,1,3和5年生存率分别为61％,33％和21％,其中N1．1期、N2期患者的中位生存期分别为42和13个月（x^2=14．3,P=0．000）;病理类型及手术方式对预后无影响;术前及术中化学治疗（化疗）的患者预后好于术前及术中未化疗者,中位生存期分别为39和14个月（x^2=5．0,P=0．025）。结论肺癌累及上腔静脉进行手术治疗可行,无纵隔淋巴结转移者预后较好,应尽可能手术治疗;术前或术中化疗值得推荐。     

乳腺癌淋巴管生成与血管内皮生长因子-C、环氧化酶-2表达的关系

目的探讨血管内皮生长因子（VEGF）-C、环氧化酶（COX）-2在乳腺癌组织中的相互表达关系及与淋巴管生成和预后的关系。方法应用免疫组织化学法检测70例乳腺癌组织COX-2与VEGF-C蛋白的表达，并用淋巴管内皮细胞特异性抗体D2-40标记淋巴管，计数肿瘤淋巴管密度（LVD），结合临床病理特征和随访资料进行分析。结果（1）乳腺癌组织COX-2、VEGF-C高表达率分别为65．7％（46／70）和42．8％（30／70）。COX-2与VEGF-C蛋白表达之间存在显著相关（r=0．529，P〈0．01）。（2）COX-2蛋白的高表达与淋巴结转移、LVD和淋巴管浸润呈正相关（P〈0．05），与雌激素受体状态、无病生存率和总生存率呈负相关（P〈0．05）。VEGF-C蛋白的高表达与淋巴结转移、LVD、淋巴管浸润呈正相关（P〈0．05），与组织学分化、无病生存率和总生存率呈负相关（P〈0．05）。结论COX-2可能通过上调VEGF-C表达来促进乳腺癌淋巴管生成，从而导致淋巴结转移的发生。COX-2和VEGF-C的高表达提示乳腺癌患者容易出现淋巴结转移和预后不良。     

胆囊腺鳞癌和鳞癌与胆囊腺癌的临床对比研究

目的 探讨胆囊腺鳞癌和鳞癌的临床特点.方法 回顾性分析112例胆囊癌患者的临床资料,将其中11例胆囊腺鳞癌和鳞癌的临床特点和预后与同期收治的101例胆囊腺癌进行比较.结果 腺鳞癌/鳞癌组与腺癌组的肿瘤浸润分期为13或T4的比例分别为100%和53%,两组的差异有统计学意义(X2=7.013,P=0.008).腺鳞癌/鳞癌与进展期腺癌(T3或T4期)的远处转移发生率分别为0和35%,差异有统计学意义(X2=3.900,P=0.048),两组的淋巴结转移率为82%和87%(X2=0.000,P=1.000).腺鳞癌/鳞癌组和进展期的腺癌组的胃肠道侵犯发生率分别为45%和15%,差异无统计学意义(X2=3.618,P=0.054).两组的中位生存期分别为5个月和4个月,生存差异无统计学意义(X2=0.359,P=0.549).结论 胆囊腺鳞癌和鳞癌的局部侵袭性强,而远处转移率低.淋巴结转移情况与腺癌相似.     

MDR1基因产物在非小细胞肺癌中的表达研究

目的探讨ＭＤＲ１基因表达产物Ｐ－糖蛋白（Ｐ－ｇｐ）在非小细胞肺癌中的表达水平及其临床意义。方法采用免疫组织化学标记链亲和素－生物素法检测１２６例非小细胞肺癌标本中Ｐ－ｇｐ的表达。结果（１）Ｐ－ｇｐ总的阳性表达率为５６．３％（７１／１２６）；（２）腺癌与鳞癌之间，鳞癌与腺鳞癌之间Ｐ－ｇｐ的表达阳性率无显著差异（Ｐ＞０．０５），但腺鳞癌Ｐ－ｇｐ的阳性表达率高于腺癌（Ｐ＜０．０５）；（３）Ｐ－ｇｐ的表达与性别、年龄、肿瘤生长部位、病理分期及是否伴有淋巴结转移无关。结论Ｐ－ｇｐ在非小细胞肺癌中有较高的阳性表达率，且与病理类型有一定关系，提示在非小细胞肺癌尤其是Ｐ－ｇｐ高度表达类型肺癌的化疗中，应重视Ｐ－ｇｐ介导的多药耐药性。     

Nonsmall cell lung carcinoma with neuroendocrine differentiation--an entity of no clinical or prognostic significance

The existence of non-small cell lung carcinoma with neuroendocrine differentiation as a distinct entity and its relevance for prognostic and treatment purposes is controversial. This study assesses the frequency and biologic and prognostic significance of neuroendocrine (NE) expression of synaptophysin (SNP), chromogranin (Ch), and neural cell adhesion molecule (N-CAM) using tissue microarray (TMA) and immunohistochemistry. Six hundred nine nonsmall cell lung carcinomas (NSCLCs) were reviewed for subclassification. TMA blocks were made using duplicate 0.6-mm-diameter tissue cores and slides stained with SNP, Ch, and N-CAM. Immunoreactivity was considered if 1% or more of tumor cells were positive. Hematoxylin and eosin-stained sections were subclassified as: 243 adenocarcinoma (ACA), 272 squamous cell carcinoma (SCC), 35 large cell carcinoma, 32 non-small cell carcinoma NOS, and 6 other (carcinosarcoma, giant cell carcinoma). Positivity for either marker was identified in 13.6% of NSCLC (76/558). NSCLC showed reactivity for Ch in 0.4% of cases (2/524), for SNP in 7.5% of cases (39/521) and for N-CAM in 8.6% of cases (44/511), whereas only 0.2% of cases (1/517) showed coexpression of SNP and Ch and none of all 3 markers. The assessment of NE differentiation in NSCLC is unnecessary and expensive and is of no clinical or prognostic significance. SNP or N-CAM stains a small minority of NSCLC, whereas Ch immunoreactivity is less common. Positivity for any 2 NE markers is rare. SNP is more likely to be expressed in adenocarcinoma (P=0.01) and N-CAM in squamous-cell carcinoma (P=0.008). Otherwise there was no correlation between immunoreactivity and tumor morphology. Disease specific and overall survival is not influenced by NE differentiation and therefore non-small cell lung carcinoma with neuroendocrine differentiation should not be a subclass distinct from the other NSCLC.     

Do women live longer following lung resection for carcinoma?

OBJECTIVE: To determine whether patient gender affects the outlook following lung resection for non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: Prospectively collected data on 833 patients undergoing lung resection for NSCLC between 1990 and 2000 in a single unit were analysed. RESULTS: 581 patients were male (mean age 64.7 +/- 7 years) and 252 were female (mean age 62.6 +/- 7.8 years) (P=0.006). Male patients were more likely to have a history of ischaemic heart disease (P=0.03), to have poorer preoperative spirometry as demonstrated by their % predicted FEV1 (P=0.02) and to need pneumonectomy (P=0.0001) than their female counterparts. Squamous cell carcinoma was the predominant histological cell type in men and adenocarcinoma in women (P<0.0001). There was a trend towards a lower pathological stage among women, but this was not significant. Operative mortality for men was 4.6 and 1.2% for women (P=0.01). Overall 5-year survival for men was 34.2 +/- 2.65% and 47.5 +/ - 4.2% for women (P=0.001) and, for the hospital survivors, was 36.5 +/- 2.7% and 48.1 +/- 4.2%, respectively (P=0.01). On univariate analysis, older age, the need for pneumonectomy and higher pathological stage were significant adverse factors whereas squamous cell type and female gender were significant favourable factors for survival (P<0.05). On Cox proportional hazards model (with and without hospital deaths), pathological stage (P<0.0001), female gender (P=0.0006) and squamous cell type (P=0.001) were independent predictors of survival. The survival was significantly better for women having squamous cell (P=0.01) or non-squamous cell cancers (adenocarcinoma and other) (P=0.002). Regarding the stage, women had a significant survival advantage at pathological stage I (P=0.01) and a relatively better survival at stage II and stage III disease (P=0.3). CONCLUSIONS: This study suggests that female gender exerts a significant positive effect on survival following lung resection for NSCLC. This effect is pronounced at early disease stage and persists after adjusting for important differences in the clinical, histo-pathological features and extent of pulmonary resection between male and female patients.     

Combined Resection of Great Vessels or the Heart for Non-Small Lung Cancer

Objectives: The surgical indications for non-small cell lung cancer (NSCLC) infiltrating a great vessel or the heart are controversial. We assessed clinical features and surgical outcomes of patients with non-small cell lung cancer who underwent combined resection of a lung and great vessel.Methods: Fourteen patients underwent great vessel resection under a lobectomy (n = 9), sleeve lobectomy (n = 2), or pneumonectomy (n = 3) between 2000 and 2011, in whom the aorta was resected in 6, superior vena cava in 5, right atrium in 1, and left atrium in 2. The histological types were adenocarcinoma (n = 8) and squamous cell carcinoma (n = 6).Results: Complete resection was performed in 12 patients. Of all patients, 7 had pN0 disease, 2 had pN1, and 4 had pN2. The postoperative morbidity rate was 28.6% and mortality rate was 7.1%. The 5-year survival rate was 26.8% for all patients, 46.9% for those with an adenocarcinoma, 0% for those with a squamous cell carcinoma, 53.6% for those with pN0, and 0% for those with pN1-2.Conclusion: Resection of the great vessels and heart involved by NSCLC can be performed with acceptable morbidity and mortality, and results in prolonged survival in patients, with an adenocarcinoma or N0 status.     

Adenocarcinoma of the esophagus and cardia

Two hundred thirty-nine patients with carcinoma of the esophagus and cardia were seen between 1971 and 1985. Of 128 adenocarcinomas, 108 (84%) were resected. There were 111 squamous cell tumors, of which 104 (94%) were resected. Hospital mortality rate (3 months) was 19.4% in patients with adenocarcinoma and 14.4% in those with squamous cell carcinoma. It was significantly higher in the over 70 age group in both series. The 1 year survival rate in the adenocarcinoma group (52.3%) was lower than in the squamous group (59.1%), which reflects the higher operative mortality rate in the former. The 5 year survival rate was 18% in the adenocarcinoma group and 18.7% in the squamous cell group. With one exception, all patients who survived for 5 years had a Stage I tumor. Although the operative mortality was higher in the adenocarcinoma group, the prognosis was similar to that of the squamous cell carcinoma group.     

非小细胞肺癌组织中上皮钙黏蛋白的表达及与预后的关系

目的探讨非小细胞肺癌(NSCLC)组织中上皮钙黏蛋白(Ecadherin)的表达及与预后的关系。方法用组织阵列仪构建365例NSCLC患者手术切除癌组织标本的组织芯片,对该芯片进行Ecadherin免疫组化染色,并分析Ecadherin表达与临床病理资料及生存预后的关系。365例中,鳞癌116例、腺癌199例、腺鳞癌等组织类型50例。结果Ecadherin蛋白主要在肿瘤细胞的胞膜和细胞质中表达,有32.1%(117/365)为Ecadherin低表达。Ecadherin低表达与淋巴结转移(χ2=16.430,P=0.001)、肿瘤细胞低分化(χ2=9.243,P=0.010)以及临床病理分期(χ2=9.421,P=0.024)呈正相关,而与病理类型无明显关系;Ecadherin表达与NSCLC预后差密切相关(P<0.0001)。多因素生存分析表明,Ecadherin表达是NSCLC预后差的独立预后因素(P<0.001)。结论Ecadherin可能与NSCLC的进展有关,其表达状态是NSCLC独立预后因素。     

Prognostic value of the histological subtype in completely resected non-small cell lung cancer

Non-small cell lung cancer (NSCLC), which includes several different histological subtypes, is usually treated by the same strategy. However, the biological behavior of each cell type appears to be different. We retrospectively reviewed the clinical records of 1119 consecutive NSCLC patients who underwent a complete resection, in order to investigate whether a histological cell type is a powerful prognostic factor. The overall 5- and 10-year survivals of the patients with adenocarcinoma (AD), squamous cell carcinoma (SQ), large cell carcinoma (LA), and adenosquamous cell carcinoma (AS) were 54.2 and 40.2%, 51.6 and 30.3%, 40.9 and 18.7%, and 35.1 and 30.1%, respectively. The AD patients had a significantly better survival than the non-AD patients in Stage I (P=0.0004), whereas the SQ patients had a better survival than the non-SQ patients in Stage II (P=0.018). A multivariate survival analysis indicated the AD patients to have a significantly better survival than the SQ patients in Stage IA (P=0.04), while the SQ patients had a better survival than the AD patients in Stage II (P=0.03). These above observations suggest that the prognosis after complete resection is different between adenocarcinoma and squamous cell carcinoma in Stage IA and II.     

细胞S期激酶相关蛋白2、p16蛋白在非小细胞肺癌中的表达及其临床意义

目的 观察细胞s期激酶相关蛋白2(SKP2)、p16蛋白在非小细胞肺癌(NSCLC)组织中的表达,探讨它们之间的关系及其临床意义.方法 利用组织芯片和免疫组织化学技术检测SKP2、p16蛋白在89例非小细胞肺癌,10例肺良性病变组织中的表达.结果 NSCLC组织中SKP2、p16蛋白表达阳性率分别为(23.52±13.57)%、(44.72±15.97)%,均与肺良性病变组织差异有统计学意义(2.91±1.27)%、(91.13±6.57)%(P＜0.01).SKP2蛋白在NSCLC组织中的表达水平与细胞分化程度,病理类型,TNM分期密切相关(P＜0.01),而与淋巴结转移差异无统计学意义(P＞0.05).p16蛋白在NSCLC组织中的表达水平与细胞分化程度,病理类型,TNM分期,淋巴结转移密切相关(P＜0.01).NSCLC组织中SKP2、p16蛋白表达呈负相关(r=-0.309,P＜0.01).NSCLC组织中SKP2蛋白表达率与患者生存时间呈负相关(r=-0.241,P＜0.01),p16蛋白表达率与患者生存时间呈负正相关(r=0.144,P＜0.01).结论 SKP2蛋白表达增高与p16蛋白表达降低共同在NSCLC的发生发展中起促进作用,且它们对NSCLC患者的预后也有相反的影响.     

食管鳞癌环周切缘的临床意义分析

目的:分析食管鳞癌环周切缘情况与患者术后生存预后的关系,并探讨其与临床病理特征的相关性。方法:收集河北医科大学第四医院2017年10月至2019年3月行食管癌根治性切除术后的患者资料,所有患者临床资料完整,术后病理均为进展期鳞癌。采集并分析患者性别、年龄、T分期、N分期、肿瘤位置、病变长度、大体病理类型、脉管瘤栓、神经...