支气管肺癌的肿瘤血管与染色、病理学和预后相关性

Interrelation research of primary pulmonary carcinoma: tumor vascularity and stein vs pathological diagnosis

目的探讨肺癌肿瘤血管与染色同病理学的相关性及其对介入治疗预后的影响。方法所有患者按年龄、性别、病灶大小和位置、病理学、肿瘤供血动脉、肿瘤血管、肿瘤染色、手术方式、治疗次数、首次发病时间、首次介入治疗时间、生存时间分组统计,并输入SPSS12.0软件进行系统分析。结果40例连续血管造影随访,治疗前肿瘤染色明显者18例,肿瘤染色一般者9例,肿瘤染色欠佳者13例;末次治疗后血管造影,肿瘤染色明显者9例,肿瘤染色一般者17例,肿瘤染色欠佳者14例;治疗前后肿瘤染色改变统计学处理(P<0.01),其中支气管动脉供血35例(35/40,87.5%),同时肺动脉参与供血者4例(10%),鳞癌和腺癌支气管动脉供血32例(80%)。病理学、介入方法和生存时间之间的相关分析显示有明显统计学意义。结论肺癌的肿瘤血管与肿瘤染色同组织病理学分型不相关,而与病理学分级呈负相关,即分化程度越低,肿瘤血管和染色越丰富。鳞癌和腺癌以支气管动脉供血为主。血管内介入治疗能明显减少肿瘤血管和肿瘤染色,提高支气管动脉内治疗效果。

Objective To discuss the interrelation of tumor vascularity and stein versus cellular pathology of primary pulmonary carcinoma (PPC), and its interference with prognosis of vascular interventional management. Methods All patients underwent thoracic aortiography and followed supper-selective bronchial angiography, meanwhile pulmonary angiography of relevant segment had been undertaken. Data were inputted into SPSS 12.0 software as patient's age, sex, size and location of focus, pathology, supplied artery, tumor vascularity and stein, interventional regime, treated times, time of first interventional treatment, survival time, statistical analyses were carried out for relations of each others. Results On first angiograms of 40 cases, obvious tumor stein occurred in 27 cases, and less or no stein in 13 cases. On the last angiograms, the obvious occurred in 9 cases, the less or no stein in 31 cases. Changes of tumor vascularity and stein showed obviously statistical differences (P<0.01) between first and last interventional treatment. The relations of tumor vascularity and stein vs pathological diagnosis and its classification of PPC showed that the main supplying arteries of PPC were bronchial arteries (BA, 35/40, 87.5%), meantime, only 4 cases also supplied by pulmonary arteries (PA, 10%). Adenocarcinoma and squamous cell carcinoma were mainly supplied by BA (32,80%). Interrelations of tumor vascularity and stein versus pathology showed obvious statistical difference (P<0.01). Conclusion BA is the main supplied artery of PPC. No statistical relations demonstrated tumor vascularity and stein vs. pathology, but negative relations showed pathological cellular grading vs. tumor vascularity and stein, namely, lower level of differentiation of PLC cell, tumor vascularity and stein should be more rich and generous. Vascular interventional treatment should obviously reduce tumor vascularity and stein.