CAJ | 학술논문

目的：探讨小细胞肺癌( small cell lung cancer, SCLC)神经内分泌标志物、CKpan及TTF-1与TNM分期及患者预后的关系。方法采用免疫组化MaxVision两步法检测90例SCLC组织中NSE、CgA、Syn、CD56、CKpan及TTF-1的表达,分析患者的临床病理资料及TNM分期,电话随访计算患者的总生存期( overall survival, OS)。结果90例SCLC中多数为老年男性,男女比为5∶1,中位年龄64岁,其中Ⅰ+Ⅱ期21例,Ⅲ期30例,Ⅳ期39例。 SCLC中NSE、CgA、Syn、CD56、CKpan及TTF-1的阳性率分别为83．3%、70%、65．5%、86%、92．2%和81．1%。 Kaplan-Meier单因素分析显示TTF-1、NSE的表达与TNM分期及患者生存期相关(P<0．05)；TTF-1阳性组中位生存期为8个月,与TTF-1阴性组(5．5个月)相比差异有统计学意义(P=0．000)；NSE阳性组中位生存期为7个月,与NSE阴性组(11个月)相比差异有统计学意义(P=0．009)；TNM分期中Ⅰ+Ⅱ、Ⅲ和Ⅳ的中位生存期分别为16个月、9个月和4个月,差异均有统计学意义( P=0．000)；Cox多因素生存分析显示TTF-1表达和TNM分期是影响SCLC OS的独立预后因素。结论 SCLC多伴有神经内分泌分化,多数表达CKpan和TTF-1；其中TTF-1表达与SCLC的预后呈负相关；NSE表达与预后呈正相关；TTF-1表达和TNM分期是影响SCLC OS的独立预后因素。
목적：탐토소세포폐암( small cell lung cancer, SCLC)신경내분비표지물、CKpan급TTF-1여TNM분기급환자예후적관계。방법채용면역조화MaxVision량보법검측90례SCLC조직중NSE、CgA、Syn、CD56、CKpan급TTF-1적표체,분석환자적림상병리자료급TNM분기,전화수방계산환자적총생존기( overall survival, OS)。결과90례SCLC중다수위노년남성,남녀비위5∶1,중위년령64세,기중Ⅰ+Ⅱ기21례,Ⅲ기30례,Ⅳ기39례。 SCLC중NSE、CgA、Syn、CD56、CKpan급TTF-1적양성솔분별위83．3%、70%、65．5%、86%、92．2%화81．1%。 Kaplan-Meier단인소분석현시TTF-1、NSE적표체여TNM분기급환자생존기상관(P<0．05)；TTF-1양성조중위생존기위8개월,여TTF-1음성조(5．5개월)상비차이유통계학의의(P=0．000)；NSE양성조중위생존기위7개월,여NSE음성조(11개월)상비차이유통계학의의(P=0．009)；TNM분기중Ⅰ+Ⅱ、Ⅲ화Ⅳ적중위생존기분별위16개월、9개월화4개월,차이균유통계학의의( P=0．000)；Cox다인소생존분석현시TTF-1표체화TNM분기시영향SCLC OS적독립예후인소。결론 SCLC다반유신경내분비분화,다수표체CKpan화TTF-1；기중TTF-1표체여SCLC적예후정부상관；NSE표체여예후정정상관；TTF-1표체화TNM분기시영향SCLC OS적독립예후인소。
Purpose To explore the immunohistochemical features of neuroendocrine markers, CKpan and TTF-1 and their relationship to TNM stage and prognosis in small cell lung cancer (SCLC). Methods The expression of NSE, CgA, Syn, CD56, TTF-1 and CK-pan in SCLC tissue specimens were detected using immunohistochemical EnVision indirect method. Clinical data and TNM stage of 90 patients were collected and the overall survival ( OS) was followed up by telephone. Results Of 90 cases of SCLC, the vast majority were occured in the elderly men. The ratio of man to woman was 5 to 1. The median age was 64 years old. The stageⅠ+Ⅱ was 21 cases, 30 in stageⅢand 39 cases in stage IV. The positive rate of immunohistochemical staining of neuroendocrine markers for NSE, CgA, Syn and CD56 were 83. 3%, 70%, 65. 5% and 86%, respectively. The positive rate of CKpan, TTF-1 were 92. 2% and 81. 1%. Kaplan-Meier analysis indicated that the expression of TTF-1 and NSE were significantly correlated with the TNM stage and over-all survival of patients with SCLC (P<0. 05). The median OS was 8 months in positive expression of TTF-1, which was higher than those in negative expression of TTF1 (5. 5 months)(P=0. 000). The median OS was 7 months in NSE positive expression which was lower than those in negative expression of NSE (11 months)(P=0. 009). The median OS of stageⅠ+Ⅱ,ⅢandⅣwere 16 months, 9 months and 4 months with significant difference ( P=0. 000 ) . Cox multivariate analysis indicated the TTF-1 expression and TNM were independent prognostic factors for the OS of the SCLC patients. Conclusion Most of SCLC has neuroendocrine differentiation, expression CKpan and TTF-1. The expression of TTF-1 may be negative correlation but NSE positive correlation with the prognosis of SCLC patients. And the TTF-1 expression and TNM may be independent prognostic factors for the OS of the SCLC patients.