中心型非小细胞肺癌浸润近端支气管壁的临床病理学研究

Clinicopathological Study of Proximal Bronchial Extension in Hilar Type Non-small Cell Lung Cancer

目的:观察中心型非小细胞肺癌不同的病理组织学类型、pTNM分期、p53蛋白表达对癌细胞浸润近端支气管壁长度的影响,为术式的选择提供临床病理依据。方法:收集86例原发性中心型非小细胞肺癌的手术标本,对肿瘤至支气管切缘的管壁进行连续取材,观察组织学类型,测量癌细胞浸润近端支气管的长度。用免疫组织化学法(SP)检测p53蛋白表达。结果:Ⅲa期腺癌最长(1.91±0.36cm),Ⅰb期鳞癌最短(0.39±0.15cm)。p53蛋白阳性表达者浸润长度(0.87±0.49cm)大于表达阴性者(0.53±0.32cm),(t=3.82,P<0.01),且差异均有显著性。结论:在原发性中心型非小细胞肺癌中,病理组织学类型、pTNM分期及p53蛋白表达与癌细胞浸润近端支气管壁的长度有关,可作为选择术式的依据之一。

Objective: To investigate the effects of proximal bronchial extension of hilar type non-small cell lung cancer (NSCLC) of different types, pTNM stages and expression of p53 protein and provide a clinicopathological basis for a curative resection. Methods: Eighty-six surgical specimens of primary hilar type NSCLC were collected for this study. Macroscopic and microscopic proximal bronchial invasion lengths were measured from bronchial resection margins to tumor edges. The expression of p53 protein was determined in all cases of primary hilar type NSCLC by immunohistochemical technique. Results: The invasion length of Adenocarcinomas at stage Ⅲa was the longest (1.91±0.36cm) and that of Squamous cell carcinomas at stage Ⅰb was the shortest (0.39±0.15cm). The positive expressions of p53 protein (0.87±0.49cm) was much longer than that of negative ones(0.53±0.32cm), which was significantly different (t=3.82, P<0.01). Conclusion: The extension of invasion is correlated with the histopathologic type of cancer, TNM classification and p53 expression, which are one of clinicopathological bases for a curative resection.