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目的:探讨肺腺癌间质增生对肿瘤耐药的影响。方法:选择东营市人民医院2006-01-01-2012-12-30收治的具有完整临床病理及随访资料的肺腺癌患者268例作为研究对象。将病例按IASLC/ATS/ERS肺腺癌分类,根据间质增生程度分成间质增生0级(肺泡间隔或原位腺癌间质的宽度),Ⅰ级(肺泡间隔宽度2倍),Ⅱ级(肺泡间隔间质宽度3倍),Ⅲ级(>肺泡间隔间质宽度3倍)。268例患者中共264例患者接受化疗,并被纳入分析。检测肿瘤ERCC1和BRCA1蛋白表达,分析其与临床病理因素的相关性,探讨肺腺癌间质增生对耐药的影响。结果:ERCC1和BRCA1的表达与肺腺癌患者性别、肿块大小、淋巴结转移情况、组织学亚型和肿瘤分期均无相关性,P值均>0.05。肺腺癌间质增生Ⅰ级,ERCC1阳性组与阴性组有效率分别为31.03%和79.55%,差异有统计学意义,P<0.01;Ⅱ级,有效率分别为47.91%和77.78%,差异有统计学意义,P<0.01;Ⅲ级,有效率分别为19.05%和18.00%,差异无统计学意义,P>0.05。间质增生Ⅰ级,BRCA1阳性组与阴性组有效率分别为53.85%和100.00%,差异有统计学意义,P<0.05;Ⅱ级,有效率分别为61.39%和89.47%,P<0.05;Ⅲ级,有效率分别为16.00%和23.81%,差异无统计学意义,P>0.05。结论:ERCC1和BRCA1的表达与肺腺癌的亚型和分期无明显相关性。间质增生程度低的肺腺癌,以铂类为主的治疗有效率高;间质增生程度高的病例,疗效较低。肺腺癌的间质增生是独立于肿瘤细胞耐药之外影响肿瘤耐药的重要因素。
Objective: To investigate the effect of interstitial lung adenocarcinoma on tumor resistance. Methods: A total of 268 lung adenocarcinoma patients with complete clinical pathology and follow-up data from January 2006 to January 12, 2012 in Dongying Municipal People’s Hospital were selected as research objects. The cases were classified according to the IASLC / ATS / ERS lung adenocarcinoma classification according to the degree of interstitial hyperplasia interstitial hyperplasia grade 0 (the width of the alveolar septa or in situ adenocarcinoma of the stroma), grade Ⅰ (2 times the width of the alveolar septum), grade Ⅱ (Three times the width of the alveolar compartment), grade III (> three times the width of the alveolar compartment). A total of 264 patients in 268 patients underwent chemotherapy and were included in the analysis. Detect the expression of ERCC1 and BRCA1 protein in tumor, analyze the correlation with clinicopathological factors and explore the effect of interstitial hyperplasia of lung adenocarcinoma on drug resistance. Results: The expression of ERCC1 and BRCA1 had no correlation with the gender, tumor size, lymph node metastasis, histological subtypes and tumor staging in patients with lung adenocarcinoma, P> 0.05. The positive rates of grade 1 in lung adenocarcinoma were 31.03% and 79.55% respectively for ERCC1 positive group and negative group, the difference was statistically significant (P <0.01). The effective rates of grade Ⅱ and group Ⅱ were 47.91% and 77.78%, respectively Statistical significance, P <0.01; Grade Ⅲ, the effective rates were 19.05% and 18.00% respectively, with no significant difference (P> 0.05). The grade of interstitial hyperplasia grade Ⅰ, BRCA1 positive group and negative group were 53.85% and 100.00%, the difference was statistically significant, P <0.05; Ⅱ grade, the effective rates were 61.39% and 89.47%, P <0.05; Ⅲ Grade, the effective rate was 16.00% and 23.81%, the difference was not statistically significant, P> 0.05. Conclusion: The expression of ERCC1 and BRCA1 has no significant correlation with the subtype and stage of lung adenocarcinoma. The degree of interstitial hyperplasia of lung adenocarcinoma, platinum-based treatment of high efficiency; high degree of interstitial hyperplasia cases, the effect is low. Interstitial hyperplasia of lung adenocarcinoma is an important factor that affects tumor resistance independent of tumor cell resistance.