Bozzetti C, Franciosi V, Crafa P, Carbognani P, Rusca M, Nizzoli R, Guazzi A, Naldi N, Cocconi G
Divisione di Oncologia Medica, Azienda Ospedaliera di Parma, Via Gramsci 14, 43100, Parma, Italy.
Lung Cancer. 2000 Jul;29(1):33-41. doi: 10.1016/s0169-5002(00)00095-7.
A number of biological and predictive markers of non-small cell lung cancer (NSCLC) have been sought, but these have so far been mainly evaluated on surgically resected specimens. Given that fine needle aspiration biopsy (FNAB) is being increasingly used in the diagnosis of NSCLC, its application could be extended to the immunocytochemical detection of biological parameters at the time of diagnosis before surgery. In order to assess the reliability of estimating biological markers on fine needle aspirates (FNAs) from NSCLC, the aim of this study was to compare Ki67 growth fraction, p53 and bcl-2 protein expression as revealed by the immuncytochemical assessment of FNAs obtained from surgical samples with the immunohistochemical results obtained from the corresponding histological sections. FNAs were performed on surgical specimens obtained from 29 NSCLC patients. Ki67, p53 and bcl-2 were cytologically and histologically evaluable in respectively 25, 27 and 19 cases. Concordance between FNAs and corresponding paraffin sections was 84% for Ki67, 93% for p53 and 95% for bcl-2. All of the specimens whose biological parameters were studied by immunocytohistochemistry also underwent flow cytometric DNA analysis of FNAs taken from fresh surgical specimens. Of the 29 cases, 22 were aneuploid and seven diploid. The S-phase fraction (SPF) was evaluable in 62% of cases. Comparison of SPF results on FNAs with Ki67 values evaluated on the corresponding histologic and cytologic specimens, revealed a significant correlation only with histology. Good reproducibility was also found in relation to the immunocytochemical results obtained on FNAs from different areas of the same tumour, showing that tumour heterogeneity does not affect the method. The concordance between the immunocytochemical and immunohistochemical results suggests that FNAB may be a reliable procedure for the biological characterization of NSCLC. Given its limited invasiveness, FNAB could be used in vivo for the preoperative assessment of biological parameters in patients with operable or metastatic NSCLC.
人们一直在寻找非小细胞肺癌（NSCLC）的多种生物学和预测性标志物，但迄今为止，这些标志物主要是在手术切除的标本上进行评估的。鉴于细针穿刺活检（FNAB）在NSCLC诊断中的应用越来越广泛，其应用可以扩展到术前诊断时对生物学参数的免疫细胞化学检测。为了评估从NSCLC细针穿刺抽吸物（FNA）中估计生物学标志物的可靠性，本研究的目的是比较通过对手术样本获得的FNA进行免疫细胞化学评估所揭示的Ki67增殖分数、p53和bcl-2蛋白表达与从相应组织学切片获得的免疫组织化学结果。对29例NSCLC患者的手术标本进行了FNA。Ki67、p53和bcl-2在细胞学和组织学上分别可评估25例、27例和19例。FNA与相应石蜡切片之间的一致性，Ki67为84%，p53为93%，bcl-2为95%。所有通过免疫细胞组织化学研究生物学参数的标本，也对取自新鲜手术标本的FNA进行了流式细胞术DNA分析。29例中，22例为非整倍体，7例为二倍体。62%的病例可评估S期分数（SPF）。将FNA的SPF结果与在相应组织学和细胞学标本上评估的Ki67值进行比较，发现仅与组织学有显著相关性。在同一肿瘤不同区域的FNA获得的免疫细胞化学结果方面也发现了良好的重复性，表明肿瘤异质性不影响该方法。免疫细胞化学和免疫组织化学结果之间的一致性表明，FNAB可能是NSCLC生物学特征化的可靠方法。鉴于其侵袭性有限，FNAB可用于对可手术或转移性NSCLC患者进行体内生物学参数的术前评估。
