肺腺癌瘤周微淋巴管密度的检测及其预后意义

目的　检测肺腺癌瘤周微淋巴管密度（ＬＭＶＤ），探讨其与患者预后之间的关系。方法　应用免疫组化ＳＰ法检测６５例肺腺癌Ｄ２-４０蛋白表达并计数Ｄ２-４０表达阳性瘤内、瘤周的ＬＭＶＤ，分析其与患者临床病理特征的关系；观察患者总生存时间。结果　肺腺癌Ｄ２-４０表达阳性瘤周的ＬＭＶＤ为１１.５６±１０.７３，明显高于瘤内的３.９６±１.１５（Ｐ＜０.００１）。Ｄ２-４０表达阳性瘤周的ＬＭＶＤ与淋巴结转移密切相关（Ｐ＝０.００３）。瘤周高ＬＭＶＤ组（＞１０）中位生存时间为１３个月（９５％ＣＩ：１１.４～１４.６个月），瘤周低ＬＭＶＤ组（≤１０）中位生存时间为３１个月（９５％ＣＩ：１７.８～４４.２个月），两组间差异有统计学意义（Ｐ＝０.００５）。多因素分析显示，瘤周ＬＭＶＤ、有无淋巴结转移和ｐＴＮＭ分期是独立的预后因素。结论　Ｄ２-４０表达阳性的瘤周ＬＭＶＤ可以用于预测肺腺癌的预后。

Detection of peritumoral lymphatic microvessel density in lung adenocarcinoma and its prognositic significance

Objective To detect the peritumoral lymphatic microvessel density（LMVD） in lung adneocarcinoma and investigate its relationship with patients＇ prognosis. Methods D2-40 was detected by immunohistoehemistry（ SP method）in 65 patients with lung adenocarcinoma in order to count intratumoral and peritumoral positive LMVD. Then, their correlations with clincopathological features were analyzed and overall survival times of these patients were examined. Results I）2-40 positive peritumoral LMVD in lung adenocarcinoma was 11.56±10. 73, which was higher than intratumoral LMVD （ P 〈 0. 001 ）. D2-40 positive peritumoral LMVD was related to lymph node metastasis （P = 0. 003 ）. Median survival time of patients with high peritumoral LMVD （ 〉 10 ） and low peritumoral LMVD（~〈10） were 13 months（95% CI：11. 4-14. 6） and 31 months（95% CI：17. 8-44. 2） , respectively. There were significant differences between the two groups（ P = 0. 005 ）. Multivariate analysis showed that peritumoral LMVD, with or without lymph node metastasis and p-TNM staging were independent prognostic factors. Conclusion D2-40 positive peritumoral LMVD may predict the prognosis of lung adenocarcinoma.