Ⅰ期肺腺癌患者肿瘤经肺泡腔隙扩散的临床病理特征及意义  

Clinicopathologic characteristics and significance of tumor spread through air spaces in stage I lungadenocarcinoma

作　　者：徐艳[1,2] 吴楠 常立功[4] 涂频 周晓蝶[3] 石群立 黄培林[1] 

机构地区：[1]东南大学医学院病理与病理生理学系,江苏省南京市210009 [2]解放军杭州疗养院特勤疗养科 [3]南京军区南京总医院病理科 [4]南京市第一医院呼吸科

出　　处：《江苏医药》2017年第19期1391-1393,1397,F0002,共5页Jiangsu Medical Journal

摘　　要：目的探讨Ⅰ期肺腺癌患者肿瘤经肺泡腔隙扩散（STAS）的临床病理特征及意义。方法光镜下观察276例Ⅰ期肺腺癌的HE染色切片,记录STAS的类型和扩散距离,分析STAS与临床病理特征及预后的关系。结果 276例中,93例（33.7%）出现STAS,表现为微乳头结构、实性细胞岛和单个肿瘤细胞扩散三种组织类型,距肿瘤主体的扩散距离为0.4~12.0mm。肿瘤≥2.7cm、有坏死、脉管浸润、临床分期Ⅰb和有复发或转移的患者,STAS阳性比例高（P〈0.05）;多元回归分析显示,STAS阳性可以作为Ⅰ期肺腺癌预后不良的独立因素（P〈0.05）。结论 STAS是肺腺癌一种新的浸润方式,是影响Ⅰ期肺腺癌患者预后的重要因素。Objective To explore the clinicopathologic characteristics and significance of tumor spread through air spaces（STAS） in stage I lung adenocarcinomas. Methods The HE staining slices of 276 patients with stage I lung adenocarcinoma were observed by microscope, after which the histological pattern was determined and the distance of STAS from tumor edge was measured. The correlation of STAS and clinicopathologic characteristics and prognosis was analyzed. Results Of 276 patients, 90 cases （33.7M） showed STAS, which manifested as three histological patterns of rnicropapillary, solid tumor island and single tumor cell spread. The distance of STAS from tumor edge was 0. 4-12. 0 mrn. The percentage of the cases with STAS was significantly higher in the patients with tumor size ≥ 2. 7 cm, neoplastic necorsis, vascular invasion, clinical stage I b and recurrence or metastasis（PM0. 05）. Multivariate regression analysis showed that positive STAS could be taken as an independent factor for poor prognosis of the patients with stage I lung adenocareinomas （P〈0. 05）. Conclusion STAS is a new pattern of lung adenocarcinoma invasion and is an important factor to effect the prognosis of the patients with stage I lung ad

关 键 词：肺腺癌 肺泡腔隙扩散 预后 

分 类 号：R734[医药卫生—肿瘤]