多聚唾液酸在术后肺鳞癌的表达及与预后的关系

Prognostic Significance of Polysialic Acid Expression in Resected Squamous Cell Lung Cancer

目的:探讨多聚唾液酸(PolysialicAcid,PSA)在术后肺鳞癌预后中的应用。方法:选择1995年1月～1997年12月在我院行肺癌切除术的139例肺鳞癌患者进行术后随访,126例患者获随访。将切除标本进行NCAM及PSA免疫组化SABC法染色。结果:126例Ⅰ～Ⅲa期患者,PSA表达与TNM分期无显著性差异(P>0.05)。PSA阳性患者5年生存率(33.3%)与PSA阴性患者5年生存率(53.1%)无显著性差异(P>0.05),但其中Ⅰ期患者PSA阳性和PSA阴性的5年生存率分别为42.9%和84.6%(P<0.05),Ⅱ期患者5年生存率分别为20.0%和64.5%,说明Ⅰ期、Ⅱ期PSA阳性患者预后较差。此外,当PSA表达呈阳性时,Ⅰ期、Ⅱ期和Ⅲa期患者术后生存率无差别(P>0.05)。结论:PSA的表达是预测Ⅰ期、Ⅱ期肺鳞癌术后患者预后不良的重要因素。

Objective: To study the prognostic significance of PSA overexpress in resected squamous cell lung cancer. Methods: 139 squamous cell lung cancer patients underwent radical resection from 1995.01~1997.12 in this hospital were followed. Of which 126 patients replied. All sections from each specimen were stained with immunohistochemical SABC method. Results: PSA was expressed in 30 of 126 (23.8%) patients, all of them were stage -a patients,and the relationship of PSA expression was not related with TNM (P>0.05). The 5-year survival rate for those with PSA-positive and PSA-negative cases were 33.3% and 53.1% respectively, there were no significant difference(P>0.05). As for the patient of stage I, the 5-year survival rates for those with PSA-positive and PSA-negative tumors were 42.9% and 84.6% (P<0.05), and for p-stage patients those were 20.0% and 64.5% respectively. It significantly demonstrated a worse prognosis for the p-stage I and p-stage PSA-positive patients. Additionally, there proved to be no difference in the postoperative survival among p-stage Ⅰ, Ⅱ and Ⅲa patients when PSA expression was positive(P>0.05). Conclusion: Statistical analysis confirmed that the PSA expression was an independent factor to predict a poor prognosis in resected p-stage Ⅰand Ⅱ squamous cell lung cancer patients.