弹力纤维在肺腺癌组织中的分布量与患者临床特征和预后的关系

The distribution of elastic fiber in lung adenocarcinoma and its relationship with clinical characteristics and prognosis

目的探讨弹力纤维在肺腺癌组织中的分布量与患者临床特征和预后的相关性。方法收集安徽医科大学第一附属医院2012年1月至2014年8月术后病理诊断为肺腺癌的标本123例。所有病理标本行苏木精-伊红、弹力纤维染色,观察弹力纤维在肺腺癌中的分布量,同时依据弹力纤维在癌组织中量的多少,将弹力纤维量的表达分为I级、II级、III级3个等级,术后随访5~66个月,分析弹力纤维3个等级与肺腺癌的临床特征和预后的关系。结果 123例肺腺癌中,弹力纤维I级60例(48.78%),II级23例(18.70%),III级40例(32.52%);单因素分析显示,3组弹力纤维分级患者一般资料比较显示,年龄、性别,差异无统计学意义(P均>0.05),肿瘤直径、淋巴结分期和病理类型,差异有统计学意义(P均<0.05)。随访结果显示,123例肺腺癌中,弹力纤维I级、II级、III级患者的总生存率分别为60.00%、79.30%、95.00%,弹力纤维III级患者的总生存率高于I级、II级,差异有统计学意义(P<0.05)。COX多因素分析显示,肿瘤直径、淋巴结分期是影响肺腺癌预后的独立危险因素(P均<0.05),弹力纤维分级与患者预后无关(P>0.05)。结论弹力纤维明显增生的肺腺癌患者预后较好,但弹力纤维增生不是影响肺腺癌预后的独立危险因素。

Objective To explore the distribution of elastic fiber in lung adenocarcinoma and its relationship with clinical features and prognosis. Methods 123 cases of lung adenocarcinoma conducted between January 2012 and August 2014. All of the samples dyed in he-matoxylin -eosin（HE） and EF. According to the distribution of elastic fiber in liang adenocarcinoma, all cases were categorized into three elastic fiber patternsEFP I,EFP II,EFP III. Then analyzed its relationship with clinical characteristics and prognosis of lung adenocarcinoma. The follow - up time was 5 ~ 66 moths. Results In 123 cases of lung adenocarcinoma, Inclouding 6 0 （48. 78% ） ,2 3 （ 18. 70% ） ,4 0 （3 2 . 52% ） cases presenting as EFP I,EFP II,EFP III. Single factor analysis showed： the elastic fiber grading in lung adenocarcinoma was no significant difference with the patient^ age and sex（P 〉 0 .0 5） ,but was correlated with tumor diameter ,lymph node staging and pathological type（i〉 〈 0. 05 ） . （ 2 ） The follow - up results showed that ： In 123 cases of lung adenocarcinoma, the overall survival rate of patients with EFP III was sig-nificantly higher than EFP I and EFP II. Three different levels in the EF survival rate was EFP 1 （6 0 . 00% ） , EFP 11（79. 30% ） , EFP III （95.00% ） ,showing significant differences（P 〈 0 .0 5）. According to multiply factors analysis,the diameter of tumor and lymph gland were the independent factor which affect adenocarcinoma of lung（ P 〈 0 .0 5 ） . But elastic fiber was not associated with prognosis（P 〉 0 .0 5）. Con- dusion The prognosis of patients with obvious proliferation of EF is better,but EF hyperplasia is not an independent risk factor for prognosis.