[局部晚期非小细胞肺癌患者无区域淋巴结转移时肿瘤的血管侵犯]

[Vascular invasion by tumor in the absence of regional lymph node metastases in patients with locally advanced non-small cell lung cancer].

作者信息

Akopov A L, Dvorakovskaia I V

出版信息

Vopr Onkol. 2004;50(4):417-20.

Abstract

The study included 45 patients radically operated for locally advanced (T3, T4) non-small cell lung cancer (NSCLC), free from metastasis to the regional lymph nodes. The histological subtypes were: squamous cell cancer (40; 89%), adenocarcinoma (4; 6%) and large-cell lung cancer (1; 2%). Pathomorphological stage: IIb (p T3N0M0)--35 (78%); IIIb (p T4N0M0)--10 (22%). Blood vessel invasion: tumor T3--8 (23%); T4--2 (20%). Lymph vessel invasion: T3--9 (9%) and T4--2 (2%) (p(0.05). In total, tumor invasion was reported in 16 patients: T3--12 (34%) and T4--4 (40%) (p(0.05). There was no significant difference in survival among IIb or IIIb stage NSCLC patients. None of the cases of blood vessel invasion survived 5 years after surgery. Five-year survival in patients without vascular invasion was 55% (p(001). Tumor invasion of blood and lymph vessels is associated with high probability of tumor dissemination and poor prognosis.

摘要

该研究纳入了45例接受根治性手术的局部晚期（T3、T4）非小细胞肺癌（NSCLC）患者，区域淋巴结无转移。组织学亚型为：鳞状细胞癌（40例；89%）、腺癌（4例；6%）和大细胞肺癌（1例；2%）。病理形态学分期：IIb期（pT3N0M0）——35例（78%）；IIIb期（pT4N0M0）——10例（22%）。血管侵犯：肿瘤T3期——8例（23%）；T4期——2例（20%）。淋巴管侵犯：T3期——9例（9%），T4期——2例（2%）（p<0.05）。总计，16例患者存在肿瘤侵犯：T3期——12例（34%），T4期——4例（40%）（p<0.05）。IIb期或IIIb期NSCLC患者的生存率无显著差异。血管侵犯的病例术后均无存活5年者。无血管侵犯患者的5年生存率为55%（p<0.01）。肿瘤的血管和淋巴管侵犯与肿瘤播散的高概率及不良预后相关。