Kasprzyk Mariusz, Dyszkiewicz Wojciech, Piwkowski Cezary, Gasiorowski Lukasz, Kaczmarek Elzbieta
Department of Thoracic Surgery, University of Med. Sciences, Poznan, Poland.
Lung Cancer. 2006 Feb;51(2):201-6. doi: 10.1016/j.lungcan.2005.10.014. Epub 2006 Jan 10.
This study was designed to show the relation between DNA-ploidy in patients with resectable lung cancers and their 5-year survival rate. The results are compared with those from our 2-year follow-up study of the same group of patients published in 2000. The group of 80 patients with SCC who underwent lung resection between 1995 and 96 were re-analyzed. For the statistical analysis the hazard Cox model and an exponential multiple regression model were used. The survival curves were drawn using the Kaplan-Meier method. DNA-aneuploidy was found in 45% of cancer tumors. There was no statistically significant correlation between aneuploidy and gender, age, cancer staging or grading. In the 3-year follow-up the survival rate in patients with aneuploid type tumors was significantly lower than in those with the diploid type. However, this difference was not found after 5 years of follow-up. Tumor ploidy was an independent prognostic factor only in patients between 55 and 60 years of age. The mortality rate in patients with aneuploid tumors was mainly the result of distant metastases while, in patients with diploid tumors, local recurrence was the main reason for death. In the first three years after surgical resection patients with aneuploid tumors are at higher risk of distant metastases than patients with the diploid type. Tumor ploidy can be recognized as an independent prognostic factor in younger (55-60) patients. Aneuploidy promoted the occurrence of early distant metastases while the diploid type was associated with late (after 3 years) local tumor recurrence.
本研究旨在揭示可切除肺癌患者的DNA倍体与其5年生存率之间的关系。将结果与我们2000年发表的对同一组患者进行的2年随访研究结果进行比较。对1995年至1996年间接受肺切除术的80例鳞状细胞癌患者进行了重新分析。统计分析采用Cox风险模型和指数多元回归模型。生存曲线采用Kaplan-Meier法绘制。45%的癌肿瘤中发现了DNA非整倍体。非整倍体与性别、年龄、癌症分期或分级之间无统计学显著相关性。在3年随访中,非整倍体类型肿瘤患者的生存率显著低于二倍体类型患者。然而,5年随访后未发现这种差异。肿瘤倍体仅在55至60岁的患者中是独立的预后因素。非整倍体肿瘤患者的死亡率主要是远处转移的结果,而二倍体肿瘤患者中,局部复发是主要死亡原因。在手术切除后的前三年,非整倍体肿瘤患者发生远处转移的风险高于二倍体类型患者。肿瘤倍体可被视为年轻(55 - 60岁)患者的独立预后因素。非整倍体促进早期远处转移的发生,而二倍体类型与晚期(3年后)局部肿瘤复发相关。