【摘要】 目的通过检测肿瘤组织的增殖指数及凋亡指数,探讨Ⅰ期非小细胞肺癌(NSCLC)的细胞增殖、凋亡及其与预后的关系。方法采用免疫组化和脱氧核糖核苷酸末端转移酶介导的缺口末端标记(TUNEL)法检测1994年1月至2002年7月在北京市结核病胸部肿瘤研究所住院接受手术治疗的70例Ⅰ期NSCLC患者肺癌组织的增殖指数(PI)与凋亡指数(AI)。结果肺癌组织的PI较正常肺组织明显上调,与T分期、分化和吸烟有关;肺癌组织的AI较正常肺组织明显上调,与T分期有关;Ⅰ期NSCLC细胞增殖与凋亡无明显相关。高PI组5年存活率较低PI组明显降低,分别为33.57%和73.12%,差异有显著性意义(P=0.0001)。低AI组5年存活率较高AI组明显降低,分别为41.48%和68.80%,差异有显著性意义(P=0.008)。多因素分析结果表明,PI为Ⅰ期NSCLC的独立预后因素(RR=2.473,95%CI:1.278~4.784,P=0.007)。结论Ⅰ期NSCLC为高增殖、高凋亡的亚组,细胞恶性增殖在其发生发展中起重要作用,研究细胞增殖与凋亡有助于判断预后,指导治疗。更多还原

【Abstract】 Objective To investigate the proliferation and apoptosis in stage-ⅠNSCLC and their prognostic implications.Methods Immunohistochemical technology and TUNEL assay was applied to detect proliferation and apoptosis in 118 lung cancer tissues and 30 normal lung tissues as controls.Results Proliferation Index(PI)was up-regulated in lung cancer tissues compared with that in normal lung tissues and was closely related to T-staging,differentiation and smoking.Apoptotic Index(AI)was up-regulated in lung cancer tissues compared with that in normal lung tissues and was closely related to T-staging.PI was not related to AI in stage-ⅠNSCLC.The patients with high PI had a shorter 5-year survival than those with low PI(33.57% and 73.12%,P=0.0001),and the patients with low AI had a shorter 5-year survival than those with high AI(41.48% and 68.80%,P=0.008).Multivariate analysis showed that PI was a significantly independently predictive factor for patients with stage-ⅠNSCLC(RR=2.473,95%CI:1.278~4.784,P=0.007).Conclusion Stage-ⅠNSCLC is a subgroup with high proliferation and apoptosis.Proliferation plays a more important role in stage-ⅠNSCLC.The assessment of proliferation and apoptosis may provide new insight into prognosis and adjuvant treatment for stage-Ⅰ NSCLC.更多还原