中心型非小细胞肺癌浸润近端支气管壁的临床病理学研究

• 作 者: 徐美林 田铁栓 于刚毅 张逊 杨霞 王学勤 张志尧 王嵩
• 机 构: 天津市胸科医院病理科,天津市胸科医院胸外科,天津市胸科医院气管镜室,天津市胸科医院胸外科,天津市胸科医院病理科,天津市胸科医院胸外科,天津市胸科医院病理科,天津市胸科医院胸外科 天津市300051,天
• 出 处: 中国肿瘤临床
• 发表日期: 2004年21期
• 关键词: 非小细胞肺癌 病理组织学类型 pTNM分期 p53蛋白 肿瘤浸润

目的:观察中心型非小细胞肺癌不同的病理组织学类型、pTNM分期、p53蛋白表达对癌细胞浸润近端支气管壁长度的影响,为术式的选择提供临床病理依据。方法:收集86例原发性中心型非小细胞肺癌的手术标本,对肿瘤至支气管切缘的管壁进行连续取材,观察组织学类型,测量癌细胞浸润近端支气管的长度。用免疫组织化学法(SP)检测p53蛋白表达。结果:Ⅲa期腺癌最长(1.91±0.36cm),Ⅰb期鳞癌最短(0.39±0.15cm)。p53蛋白阳性表达者浸润长度(0.87±0.49cm)大于表达阴性者(0.53±0.32cm),(t=3.82,P<0.01),且差异均有显著性。结论:在原发性中心型非小细胞肺癌中,病理组织学类型、pTNM分期及p53蛋白表达与癌细胞浸润近端支气管壁的长度有关,可作为选择术式的依据之一。

OBJECTIVE: To observe the effect of different histopathological types, pTNM staging and p53 protein expression on the length of proximal bronchial wall infiltrated by cancer cells in central NSCLC, and to provide a clinicopathological basis for the selection of surgical procedures. Methods: Totally 86 surgical specimens of primary central NSCLC were collected. The tumor-to-bronchial margins were continuously drawn from the tumor to the histological type. The length of the proximal bronchus infiltrating the cancer cells was measured. P53 protein expression was detected by immunohistochemistry (SP). Results: The longest (1.91 ± 0.36cm) stage Ⅲa adenocarcinoma and the shortest stage Ⅰb squamous cell carcinoma (0.39 ± 0.15cm). The infiltration length (0.87 ± 0.49cm) of p53 protein positive expression was significantly higher than that of negative expression (0.53 ± 0.32cm) (t = 3.82, P <0.01), and the difference was significant. CONCLUSIONS: Pathological type, pTNM stage and p53 protein expression in primary NSCLC are related to the length of the proximal bronchial wall infiltrating by cancer cells and may be used as a basis for selection of surgical procedures.