Biological characteristics and genetic abnormalities in very, young patients with lung cancer (【less than or equal】30 years of age)

回顾性分析了1981年至2001年间，来自三个机构的20例年龄小于或等于30岁的肺癌患者与国立四国癌症中心收治的1848例年龄>30岁的肺癌患者。分别采用考克斯回归模型和卡方检验评估中位生存时间（MST）和其他因素。在对所有肺癌人群（n=1851）的多变量分析中，男性、临床症状、体重减轻、高LDH水平、体力状态（PS）[大于或等于]2和晚期是独立的阴性预后因素。我们在20例年龄小于或等于30岁的患者中发现了4例粘液表皮样癌。由于粘液表皮样癌在非常年轻的人群中发病率高（p<0.001），相对早期和生存时间较长，因此将其排除在外。非吸烟者（P<0.001）和低分化非小细胞肺癌（P=0.018）的发病率在非常年轻的人群中也很高 关于我们 组在多变量分析中（n=16），临床症状，LDH水平和PS也是独立的预后因素。年轻人和普通人的存活率没有差别。根据LDH水平和临床症状，我们将非常年轻的患者分为三组; I组：LDH（正常）和无临床症状，II组：LDH（正常）和临床症状，和III组：LDH（高）和临床症状。第I、II和III组的MST分别为50.0、13.4和2.5个月（p=0.002）。排除粘液表皮样癌，在非常年轻的人群中，LDH水平和临床症状高的患者预后差。我们分析了本实验室建立的人肺癌细胞系SBC-3和EBC-2。SBC-3细胞来源于患有小细胞肺癌的24岁男性，EBC-2细胞来源于患有肺鳞状细胞癌的20岁男性。SBC-3细胞p58基因外显子5密码子175 CGG → CAC（Arg → His）杂合突变。EBC-2细胞电镜下可见桥粒和张力丝，表达耐药基因MRP 1、3、4、5和LRP，但未检测到LRP-2和P-糖蛋白。流式细胞仪检测SBC-3和EBC-2细胞均表达CD 34。少

Retrospectively, 20 patients with lung cancer aged【less than or equal】30 years from three Institutions were compared with 1848 patients of aged >30 years admitted to National Shikoku Cancer Center between 1981 and 2001. Median survival time (MST) and other factors were assessed using the Cox regression model and the chi-square test, respectively. In a multivariate analysis of the all population of lung cancer (n=1851), male gender, clinical symptoms, weight loss, a high LDH level, performance status (PS) of 【greater than or equal】2, and advanced-stage were independent negative prognostic factors. We found four patients with mucoepidermoid carcinoma among 20 patients of aged 【less than or equal】30 years. Mucoepidermoid carcinoma was excluded because of a high incidence (p<0.001) in the very young population, relatively early stage and longer survival time. The incidence of nonsmokers (p<0.001) and poorly differentiated non-small cell lung cancer (p=0.018) was also high in the very young … More group. In a multivariate analysis (n=16), clinical symptoms, LDH levels, and PS were also independent prognostic factors. There was no difference in survival between the young population and the general population. According to LDH levels and clinical symptoms, we classified the very young patients into three groups ; Group I : LDH (normal) and no clinical symptoms, Group II : LDH (normal) and clinical symptoms, and Group III : LDH (high) and clinical symptoms. The MST for group I, II and III were 50.0, 13.4, and 2.5 months, respectively (p=0.002). Excluding mucoepidermoid carcinoma, patients with a high LDH level and clinical symptoms showed poor prognosis in the very young population. Survival in the very young population was similar to that in the general population.We analyzed human lung cancer cell lines, SBC-3 and EBC-2 established in our laboratory. SBC-3 cells were derived from 24-year-old man with small-cell lung cancer, and EBC-2 cells from 20-year-old man with squamous cell carcinoma of the lung. SBC-3 cells showed heterozygous mutation codon 175 CGG to CAC (Arg to his) in Exon 5 of p58. EBC-2 showed desmosome and tonofilament be electron microscopy, and expressed drug resistant genes, MRP1, 3, 4, 5, and LRP, but LRP-2 and P-glycoprotein were not detected. Both SBC-3 and EBC-2 cells expressed CD34 by flow cytometry. Less