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

对556例肺癌手术切除标本的细胞DNA含量、增殖细胞核抗原标记指数、P53蛋白表达及AgNORs数目进行检测，并分析其与患者预后的关系。用流式细胞术检测1,901例碘化丙啶染色石蜡包埋标本的细胞DNA含量。对石蜡包埋标本进行免疫组织化学染色，检测增殖细胞核抗原和p53蛋白。对556例原发灶进行DNA倍体分析，二倍体165例(29.7%)，非整倍体391例(70.3%)。此外，检测转移灶DNA倍体时，原发灶呈二倍体分布的77例中，有26例转移灶呈非整倍体分布。原发灶的最大DI与转移瘤的DI值无相关性。这些数据表明，原发肿瘤和转移性肿瘤之间存在很高的异质性。这种异质性在腺癌中比在表皮样癌中更常见。COX多因素分析表明，DNA倍体是一个有意义的预后参数。N1-3和M1患者的增殖细胞核抗原标记指数和P53蛋白阳性率明显较高，而高表达的患者预后明显较差。肿瘤组织的核仁组成区嗜银蛋白数量高于正常肺组织。但AgNORs数目与临床病理因素之间无相关性。

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.