肺癌脑转移瘤血管生成拟态现象与病人预后分析

Vasculogenic mimicry and prognostic analysis in lung cancer brain metastasis

目的探讨肺癌脑转移瘤是否存在血管生成拟态(Vasculogenic mimicry,VM),并分析肺癌脑转移瘤VM与病人预后的关系。方法回顾性分析60例病理确诊为肺癌脑转移瘤的病例资料,应用CD34-PAS双重染色法检测脑转移瘤中是否存在VM。总结可能与预后相关的因素,包括病人年龄、性别、原发灶部位、病理类型、转移灶部位、大小、数目、治疗方法、肿瘤切除程度、KPS评分等。结果 22例脑转移瘤中发现VM,阳性率36.6%。病人术前KPS评分>70分、年龄<60岁、术后行综合治疗的病人预后较好,而VM阳性或阴性病人预后无差异。多因素分析提示:病人术前KPS评分和术后综合治疗为病人预后良好的独立预后因素。结论肺癌脑转移瘤中存在VM,VM存在与否与肺癌脑转移瘤病人预后无相关性,而病人脑转移瘤术前KPS评分>70、术后行综合治疗为病人良好预后的因素。

Objective To detect the presence of vasculogenic mimicry（VM） in lung cancer brain metastases and evaluate the role of VM in patient prognosis. Methods The clinical data, including age, gender, primary tumor location, grading, metastatic tumor location, tumor size,tumor number, therapeutic strategy, extent of tumor resection and karnofsky performance status（KPS） score, of 60 patients with lung cancer brain metastasis were analyzed retrospectively. CD34-PAS expression was detected by immunohistochemistry in the tumor tissues. Results The VM was found in 22 cases of brain metastasis and the VM-positive incidence rate in brain metastasis was 36.6%. In the patients with preoperative KPS score 70, age 60 years and postoperative comprehensive treatment, the prognosis was good. No difference in prognosis was seen between VM positive and negative patients. The multivariate analysis indicated that KPS score and comprehensive treatment after the surgery were closely related to patient prognosis. Conclusions VM exits in lung cancer brain metastasis, but does not associate with patient prognosis. Longer survival of patient is related to KPS score 70 and comprehensive treatment after surgery.