非小细胞肺癌神经内分泌分化与其生物学特性及预后关系的研究  

Research on the Relationship between Non-small Cell Lung Cancer with Neuroendocrine Differentiation and the Biological Characteristics and Prognosis

作　　者：张军[1] 郑锴[1] 郭燕[2] 张鹏[1] 战忠利[2] 

机构地区：[1]天津医科大学总医院心胸外科,天津300052 [2]天津医科大学肿瘤医院病理科,天津300060

出　　处：《中国肺癌杂志》2010年第9期873-876,共4页Chinese Journal of Lung Cancer

摘　　要：背景与目的近年来研究发现非小细胞肺癌(non-small cell lung cancer,NSCLC)具有神经内分泌(neu-roendocrine,NE)分化的特性。本研究旨在探讨NSCLC的神经内分泌分化情况及其生物学行为和预后的相关性。方法随机收集2005年1月-2007年12月、随访资料满3年的206例NSCLC术后患者的病例及石蜡标本,所有患者术前均未经放化疗。石蜡标本采用EnVision免疫组化二步法检测NSCLC神经内分泌标记物神经元特异性烯醇化酶(neuron-specific enolase,NSE)、嗜铬素A(chromogranin A,CgA)及突触素(synaptophysin,Syn)的表达。所有数据均采用SPSS统计软件进行处理,同时采用Kaplan-Meier曲线描述生存率,并行Log-rank检验。结果所有NSCLC病例中,82例伴有神经内分泌分化,阳性率为39.8%。CgA、NSE及Syn的阳性率分别为53例(25.7%)、104例(50.5%)和91例(44.2%)。统计学分析表明,非小细胞肺癌伴NE分化与癌细胞的分化程度相关,且Syn的阳性表达与癌细胞的分化程度及淋巴结转移情况相关。单因素生存分析结果经Log-rank检验示:Syn的阳性表达与患者术后生存率有关,而NE分化与患者术后生存率无明显相关性。结论 NSCLC是否伴有NE分化是判断其生物学行为的重要指标,而Syn可作为NSCLC伴NE分化的诊断标志物,Syn阳性表达提示患者预后不良。Background and objective Recently it has been proven that non-small cell lung cancer（NSCLC） also had the feature of neuroendocrine（NE） differentiation.The aim of this study is to investigate the correlation between NE differentiation of NSCLC and its biological behaviors,together with prognosis.Methods All NSCLC paraffin-embedded specimens and cases,followed up over than 3 years,were randomly obtained from 206 patients from January 2005 to December 2007,who underwent surgical resection and confirmed pathologically.All of them were not underwent radiation and chemotherapy before operation.Immunohistochemical Envision two-step method was used to detect the expressions of NSE,CgA and Syn.And all data were analyzed using SPSS statistics software and Kaplan-Meier survival curves were constructed,and Logrank test was also conducted.Results Of the 206 patients,84 cases with NE differentiation（39.8%） and CgA,NSE and Syn positive rates were 53（25.7%）,104（50.5%）,91（44.2%） respectively;a statistically significant difference between NSCLC with NE differentitation were showed.The positive expression of Syn was closely correlated with histological differentiation,lymph node metastasis.The survival of single-factor analysis by the Log-rank test showed that Syn had relation to the postoperative survival rate of patients（χ^2=4.164,P=0.041）,while the relevance between patients with NE and survival had no significant difference（P〉0.05）.Conclusion NE differentiation is an important indicator of biological behavior of NSCLC;and the detection of Syn markers of neuroendocrine differentiation may be recommended to detect NE differentiation of NSCLC,and the positive expression of Syn suggests poor prognosis.

关 键 词：肺肿瘤 神经内分泌分化 生物学特性 预后 

分 类 号：R734.2[医药卫生—肿瘤]