探讨Ⅰ期非小细胞肺癌的CT形态学征象、ERCC1表达与预后的相关性  

Correlation among CT manifestations,expression of ERCC1 and prognosis of stage Ⅰ non-small cell lung cancer

作　　者：关玉宝[1,2] 李靖煦[2] 陈淮[2] 邓怀福[2] 江梅[3,4] 杨海虹[3,4] 邱源[3,4] 何建行[3,4] 钟南山[3,4] 

机构地区：[1]南方医科大学,广东广州510515 [2]广州医学院第一附属医院放射科,广东广州510120 [3]广州医学院第一附属医院胸外科 [4]广州呼吸疾病研究所,广东广州510120

出　　处：《中国医学影像技术》2012年第12期2180-2184,共5页Chinese Journal of Medical Imaging Technology

基　　金：广东省科技计划项目(83052);广东省医学科研基金项目(A2010237)

摘　　要：目的探讨Ⅰ期非小细胞肺癌(NSCLC)的CT形态学征象与ERCC1蛋白表达及患者预后的相关性。方法收集133例具有完整胸部CT检查及手术病理结果的Ⅰ期NSCLC患者的资料,均具备完整的3年总生存期(OS)及无病生存期(DFS)。采用半定量免疫组化法分析切除肿瘤标本的ERCC1蛋白表达情况。结果Ⅰ期NSCLC术后ERCC1蛋白表达水平与患者3年DFS存在相关性(P=0.004),与3年OS无相关(P>0.05),ERCC1蛋白水平呈高表达者术后预后较好;CT所见肺癌病灶边缘不光滑、毛刺征、胸膜凹陷征与ERCC1蛋白表达水平有相关性(P<0.05),ERCC1蛋白水平呈高表达肿瘤出现边缘不光滑、毛刺征、胸膜凹陷征的比率较低。Logistic回归分析显示,病灶边缘不光滑及毛刺征与ERCC1蛋白表达水平具有相关性(P<0.05)。结论Ⅰ期NSCLC术后ERCC1蛋白水平呈高表达患者的预后较好;CT所见肿瘤边缘不光滑、短毛刺征与ERCC1蛋白表达呈显著负相关。Objective To observe CT manifestations, expression of excision cross complementation groupⅠ （ERCC1） and correlation with prognosis of stage Ⅰ non-small cell lung cancer （NSCLC）. Methods Totally 133 patients of stage Ⅰ NSCLC with complete three-year overall survival （OS） and disease-free survival （DFS） who underwent thoracic CT and pa- thology examination were included. The expression of ERCC1 for each tumor sample was evaluated by semi-quantitative immunohistochemical analysis. Results Statistical difference of three-year DFS was found （P=0. 004）, while no statistical difference of three-year OS was found （P〉0. 05） between high and low ERCC1 protein expression. Patients with high pro- tein expression of ERCC1 had better prognosis. Tumors with unclear edge, short spiculation sign and pleural indentation were statistically significantly correlated with the expression levels of ERCC1 （P〈0.05）, being in accordance with the in- cidence of positive expression for ERCC1 too. Tumors with unclear edge and short spiculation sign were significantly corre- lated with the expression of ERCC1 according to Logistic regression analysis （P〈0. 05）. Conclusion Stage I NSCLC pa- tients with high ERCC1 expression have better survival compared to those with low ERCC1 expression. Tumors with un- clear edge and short spiculation sign on CT may indicate strong potential invasion in stage Ⅰ NSCLC patients, while the low expression of ERCC1 may suggest shorter survival time.

关 键 词：肿瘤分期 癌 非小细胞肺 体层摄影术 X线计算机 预后 

分 类 号：R814.42[医药卫生—影像医学与核医学] R734.2[医药卫生—放射医学]