Bozzetti Cecilia, Nizzoli Rita, Guazzi Annamaria, Franciosi Vittorio, Cattelani Leonardo, Crafa Pellegrino, Naldi Nadia, Cascinu Stefano
Divisione di Oncologia Medica, Azienda Ospedaliera di Parma, Via Gramsci 14, 43100 Parma, Italy.
Lung Cancer. 2002 Mar;35(3):243-7. doi: 10.1016/s0169-5002(01)00423-8.
Computed tomography (CT) guided fine needle aspiration biopsy (CT-guided FNAB) represents the procedure of choice for diagnosing peripheral primary lung cancer before surgery. The aim of the present study was to assess the reliability of the immunocytochemical evaluation of biological parameters and DNA flow cytometry on cellular material obtained from non-small cell lung cancer (NSCLC) patients by CT-guided FNAB. Thirty consecutive CT-guided FNABs obtained from NSCLC patients were submitted both to the immunocytochemical evaluation of p53, Ki67, bcl-2 and to flow cytometric DNA analysis. p53, Ki67 and bcl-2 were assessable in 60% (18/30), 53% (16/30) and 48% (10/21) of the cases, respectively. Flow cytometric DNA analysis was performed in 19 out of the 30 cases and 74% (14/19) of the histograms were evaluable. Cytofluorimetric S-phase fraction (SPF), was obtained in 57% (8/14) of the cases. The results of the current study suggest that CT-guided FNAB from primary NSCLC patients may represent an effective practice for the evaluation of biologic parameters and could be useful as a preoperative procedure. The role of neoadjuvant chemotherapy in operable NSCLC is still under debate. We suppose that in the future the presurgical characterization of NSCLC could suggest the opportunity of a neoadjuvant systemic treatment aimed to improve the clinical outcome. Moreover, in locally advanced or metastatic NSCLC immunocytochemistry could help to predict the response to chemotherapy and/or radiotherapy, avoiding ineffective treatments and supporting the development of more rational therapies.
计算机断层扫描（CT）引导下细针穿刺活检（CT引导下FNAB）是术前诊断周围型原发性肺癌的首选方法。本研究的目的是评估通过CT引导下FNAB从非小细胞肺癌（NSCLC）患者获取的细胞材料进行生物参数免疫细胞化学评估和DNA流式细胞术的可靠性。对连续30例NSCLC患者进行CT引导下FNAB，同时进行p53、Ki67、bcl-2的免疫细胞化学评估和流式细胞术DNA分析。p53、Ki67和bcl-2分别在60%（18/30）、53%（16/30）和48%（10/21）的病例中可评估。30例中有19例进行了流式细胞术DNA分析，74%（14/19）的直方图可评估。57%（8/14）的病例获得了细胞荧光S期分数（SPF）。本研究结果表明，对原发性NSCLC患者进行CT引导下FNAB可能是评估生物学参数的有效方法，并且可作为术前程序。新辅助化疗在可手术NSCLC中的作用仍存在争议。我们推测，未来NSCLC的术前特征可能提示进行新辅助全身治疗以改善临床结局的机会。此外，在局部晚期或转移性NSCLC中，免疫细胞化学有助于预测对化疗和/或放疗的反应，避免无效治疗并支持更合理治疗方法的发展。
