Detection of disseminated lung cancer cells in lymph nodes: impact on staging and prognosis.
Detection of disseminated lung cancer cells in lymph nodes: impact on staging and prognosis.
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淋巴结中播散性肺癌细胞的检测：对分期和预后的影响。
DOI：
10.1016/0003-4975(95)01012-2
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发表时间：
1996
期刊：
影响因子：
--
通讯作者：
K. Pantel
中科院分区：
文献类型：
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作者：
Bernward Passlick;J. R. Izbicki;B. Kubuschok;O. Thetter;K. Pantel
背景明显可切除的非小细胞肺癌患者肿瘤复发率高的一个主要原因可能是早期肿瘤细胞播散，而当前的分期程序显然低估了这一点。方法在这项前瞻性研究中，我们通过使用单克隆抗体 Ber-Ep4 进行免疫组织化学测定，评估了早期淋巴肿瘤细胞播散到按常规组织病理学分期为无肿瘤的区域淋巴结的频率和预后意义。 结果 Ber-Ep4 阳性细胞分别在 125 名患者中的 27 名 (21.6%) 和 565 名淋巴结中的 35 名 (6.2%) 中得到证实。免疫组织化学分析导致 27 名患者中的 24 名患者的分期上调。在先前分期为 pN0 疾病的患者中，11/70 例 (15.7%) 检测到肿瘤细胞。单变量和多变量生存分析表明，检测到最小的淋巴结肿瘤细胞播散与无病生存率降低相关（对数秩检验，p = 0.0001；Cox 回归模型，p = 0.001）。结论免疫组织化学的使用使人们能够在手术时识别许多具有区域肿瘤细胞播散的患者。这些患者可能会受益于辅助治疗方案。
BACKGROUNDA major reason for the high incidence of tumor recurrences in patients with apparently resectable non-small cell lung cancer is presumably early tumor cell dissemination, which is clearly underestimated by current staging procedures.METHODSIn this prospective study we assessed the frequency and prognostic significance of early lymphatic tumor cell spread to regional lymph nodes staged as tumor free by conventional histopathology by applying an immunohistochemical assay using monoclonal antibody Ber-Ep4.RESULTSBer-Ep4 positive cells were demonstrated in 27 (21.6%) of 125 patients and in 35 (6.2%) of 565 lymph nodes, respectively. Immunohistochemical analysis resuited in an up-staging in 24 of 27 patients. In patients previously staged as having pN0 disease, tumor cells were detected in 11/70 cases (15.7%). Univariate and multivariate survival analysis showed that the detection of minimal nodal tumor cell dissemination was associated with a reduced disease-free survival (log rank test, p = 0.0001; Cox regression model, p = 0.001).CONCLUSIONSThe use of immunohistochemistry enables one to identify many patients with regional tumor cell dissemination at the time of operation. These patients might benefit from an adjuvant therapeutic regimen.