Micropapillary lung adenocarcinoma:: a distinctive histologic subtype with prognostic significance.: Case series
Micropapillary lung adenocarcinoma:: a distinctive histologic subtype with prognostic significance.: Case series
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DOI：
10.1016/j.humpath.2007.05.029
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发表时间：
2008-03-01
期刊：
影响因子：
3.3
通讯作者：
Alvarez-Fernandez, Ernitio
中科院分区：
文献类型：
--
作者：
Sanchez-Mora, Nora;Cebollero Presmanes, Maria;Alvarez-Fernandez, Ernitio
本研究的目的是评估肺腺癌微乳头状模式的预后意义，并根据其免疫组化谱确定这种类型的肿瘤的行为是否存在差异。连续切除的191例肺腺癌分为有微乳头成分的62例和无微乳头成分的129例。分别有38例和54例患者的疾病为I期。有和无微乳头成分的患者的5年生存率分别为54%和77%（对数秩P = 0.03）。在多变量生存分析中，微乳头成分被证明是一个独立的预后因素（风险比，3.2）。五个尸检病例被用来调查免疫组化概况。p53、Ki 67、c-myc、Bcl-2、表皮生长因子受体、细胞周期蛋白D1、Bax的阳性率分别为56.7%、94%、85.1%、2.9%、35.8%、43.3%、46.3%。根据不同标记物在I期微乳头状癌中的表达评估其预后价值。在单变量分析中，只有细胞周期蛋白D1表达和Bax表达与生存率显着较差相关（log rank分别为P = .03和P = .02）。我们的结论是，它是重要的认识微乳头状生长模式在肺腺癌。此外，cyclin D I和Bax似乎是预后不良的标志物。(c)2008年由Elsevier Inc.出版
The aims of the present work were to evaluate the prognostic significance of the micropapillary pattern of lung adenocarcinoma and determine whether there are differences in the behavior of this type of tumor according to its immunohistochemical profile. A series of 191 consecutively resected pulmonary adenocarcinomas were divided into those with (n = 62) and those without (n = 129) micropapillary components. The disease was stage I in 38 and 54 patients, respectively. The 5-year survival rates of patients with and without micropapillary components were 54% and 77%, respectively (log rank P = .03). In multivariate survival analysis, the micropapillary component proved to be an independent prognostic factor (hazard ratio, 3.2). Five autopsy cases were used to investigate the immunohistochemical profile. The percentages of cases positive for various markers were 56.7 for p53, 94 for Ki67, 85.1 for c-myc, 2.9 for Bcl-2, 35.8 for epidermal growth factor receptor, 43.3 for cyclin D 1, and 46.3 for Bax. The prognostic value was evaluated according to the expression of the different markers in micropapillary carcinomas in stage I. In univariate analysis, only cyclin D1 expression and Bax expression were associated with significantly worse survival (log rank P = .03 and P = .02, respectively). We conclude that it is important to recognize the micropapillary growth pattern in lung adenocarcinoma. Moreover, cyclin D I and Bax seem to be markers of a poor prognosis. (c) 2008 Published by Elsevier Inc.