岩藻糖在肺癌及其脑转移癌组织中的表达和意义

Significance of fucose expression in lung carcinoma and their brain metastases

目的 观察岩藻糖在肺癌及其脑转移癌组织中的表达 ,探讨岩藻糖与肺癌脑转移及预后的关系。方法 应用亲合组织化学染色法观察岩藻糖在 39例脑转移癌及其原发癌中的表达。结果 原发癌和转移癌均表达岩藻糖者 2 1例 ,均不表达者 12例 ,仅原发癌表达者 2例 ,仅转移癌表达者 4例 ;转移癌岩藻糖阳性强度强于原发癌 ,差异有显著性意义 (P =0 .0 0 15 ) ;转移癌岩藻糖阳性面积百分比大于原发癌 ,差异有非常显著性意义 (P =0 .0 0 1)。多因素分析发现原发癌岩藻糖阳性面积百分比、转移癌岩藻糖阳性强度对出现脑转移症状后的生存时间有显著影响。结论 原发肺癌岩藻糖阳性面积百分比及其脑转移癌岩藻糖阳性强度具有推测预后的意义。

Objective To investigate the expression of fucose in brain metastases and their primary tumors. Methods Affinity histochemistry method was used to detect the expression of fucose in lung carcinoma and their brain metastases of 39 cases with available survival data. Results Of the 39 cases, 21 cases were positive for expression of fucose and 12 cases were negative both in the primary tumor and their metastases. 2 cases showed positive only in primary tumors and 4 cases only in metastatic tumors. The positive intensity (Dm) and percentage of the positive area (Sm) of fucose in brain metastases were stronger and higher than in their primary cancers (Dp, Sp), both were statistically significant ( P =0.001 5 and P =0.001 respectively). Multivariate analysis showed that the percentage of the positive area of the primary tumor and the positive intensity of the brain metastases was the significant predictor of survival after manifestation of the brain metastasis (Tm). Conclusion Adenocarcinomas of the lung were prone to metastasize to the brain compared with other types of lung cancer. The Dm and Sm of fucose in brain metastasis was significantly stronger and higher than that of their primary tumor. The outcome of patients with brain metastasis could be predicated by Sp and Dm. Surgical resection of the primary lung cancer and their brain metastasis(es) resulted in better prognosis.