Wang Daye, Minami Yuko, Shu Yujian, Konno Sato, Iijima Tatsuo, Morishita Yukio, Noguchi Masayuki
Department of Pathology, Institute of Basic Medical Sciences, University of Tsukuba, Tsukuba-shi, Ibaraki 305-8575, Japan.
Cancer Sci. 2003 Aug;94(8):707-11. doi: 10.1111/j.1349-7006.2003.tb01506.x.
In order to characterize the relationship between background anthracosis and pulmonary adenocarcinogenesis, surgically resected tissues of 66 cases of stage I pulmonary adenocarcinoma, 4 cm or less at their greatest dimension, were examined. These cases were diagnosed based on the classification of small-sized adenocarcinoma of the lung (Noguchi et al., Cancer 75, 1995). Thirteen cases were diagnosed as types A (localized bronchioloalveolar adenocarcinoma, LBAC) and B (LBAC with alveolar collapse), 40 cases as type C (LBAC with a focus of fibroblastic proliferation), 8 as type D (poorly differentiated adenocarcinoma) and 5 as types E (bronchial gland type adenocarcinoma) and F (true papillary adenocarcinoma). The 5-year survival rate of types A and B cases was 100%, while those of type C, type D and types E and F were 52%, 48% and 39%, respectively. Nuclear accumulation of abnormal p53 protein in non-replacement type adenocarcinomas (types D, E and F) was detected more frequently than that in replacement type adenocarcinomas (types A, B and C) (P < 0.05). In each case, black dusty material was extracted from tumorous lesions and non-tumorous regions and blotted onto a nitrocellulose membrane. The anthracotic index (AI) was calculated with a densitometer. AIs of non-tumorous regions in early and replacement type adenocarcinomas (types A and B) were significantly less than in relatively advanced (type C) and poorly differentiated (type D) adenocarcinomas (P < 0.05). These results indicated that adenocarcinoma developing in heavily anthracotic lungs readily progresses to an advanced stage, or that adenocarcinoma with a less favorable prognosis tends to develop in severely anthracotic lungs.
为了阐明背景性炭末沉着症与肺腺癌发生之间的关系，我们对66例最大直径4cm或更小的I期肺腺癌手术切除组织进行了检查。这些病例依据肺小腺癌的分类标准（野口等，《癌症》75卷，1995年）进行诊断。其中13例被诊断为A类（局限性细支气管肺泡腺癌，LBAC）和B类（伴有肺泡塌陷的LBAC），40例为C类（伴有成纤维细胞增殖灶的LBAC），8例为D类（低分化腺癌），5例为E类（支气管腺体型腺癌）和F类（真性乳头状腺癌）。A类和B类病例的5年生存率为100%，而C类、D类以及E类和F类的5年生存率分别为52%、48%和39%。在非替代型腺癌（D类、E类和F类）中，异常p53蛋白的核内积聚比替代型腺癌（A类、B类和C类）更常见（P<0.05）。在每例病例中，从肿瘤病变和非肿瘤区域提取黑色粉尘状物质，并印迹到硝酸纤维素膜上。用密度计计算炭末沉着指数（AI）。早期替代型腺癌（A类和B类）非肿瘤区域的AI显著低于相对进展期（C类）和低分化（D类）腺癌（P<0.05）。这些结果表明，在炭末沉着严重的肺中发生的腺癌容易进展到晚期，或者预后较差的腺癌倾向于在炭末沉着严重的肺中发生。
