Clinical and Experimental Study on Biological Parameters of Malignancy in Lung Cancer

研究556例肺癌切除标本的细胞DNA含量、PCNA标记指数、p53蛋白表达及AgNORs数目，并评价其与患者预后的相关性。用流式细胞术测定1901个碘化丙啶染色石蜡包埋标本的细胞DNA含量。石蜡包埋标本免疫化学染色检测PCNA和p53。结果如下：1。对556例原发性肿瘤进行DNA倍性分析，其中165例（29.7%）为二倍体，391例（70.3%）为非整倍体。此外，当测量转移位点的DNA倍性时，在原发位点具有二倍体模式的77例中有26例在转移位点显示非整倍体模式。原发肿瘤的最大DI与转移性肿瘤的最大DI无相关性。这些数据表明原发性和转移性肿瘤之间存在高发生率的异质性。这种异质性在腺癌中比在表皮样癌中更常见。Cox多变量分析表明，DNA倍性是重要的预后参数。N1-3例和M1例患者的PCNA标记指数和p53蛋白阳性率均显著增高，且pna - l - i高的患者预后明显改善。p53蛋白阳性率明显低于对照组。肿瘤组织的AgNORs数量明显高于正常肺组织。但AgNORs数目与临床病理因素无相关性。

The Cellular DNA contents, labeling index of PCNA, p53 protein expression, and number of AgNORs of lung cancer were studied in 556 resected specimens, and a correlation between the prognoses of the patients and them was evaluated. The cellular DNA contents in 1,901 propidium iodide-stained paraffin-embedded specimens were measured by flow cytometry. PCNA and p53 were also measured by immunochemical staining of paraffin-embedded specimens.Results were as followed.1. When the DNA ploidy in primary tumors was analyzed in 556 cases, 165(29.7%) were classified as having a diploid pattern, whereas 391(70.3%) as aneuploid pattern. Furthermore, when the DNA ploidy in the metastatic sites was measured, 26 out of the 77 cases which had a diploid pattern in the primary sites, showed an aneuploid pattern in the metastatic sites. The maximum DI in the primary tumor did not correlate with that in in the metastatic tumor. These data suggests that a high incidence of heterogeneity between the primary and metastatic tumors exists. This heterogeneity was observed more frequently in adenocarcinoma than in epidermoid carcinoma. Cox's multivariate analyses clarified that DNA ploidy was a significant prognostic parameter.2. PCNA labeling index and p53 protein positive rate of N1-3 cases and M1 cases were significantly higher, and prognoses of the cases with high PCNA-L.I. and p53 protein positive rate were significantly poorer.3. Number of AgNORs of the tumors were higher than that of normal lung tissue. But no correlation was observed between number of AgNORs and clinicopathological factors.