细支气管肺泡癌成分在肺腺癌中的预后价值

Prognostic value of bronchioloalveolar carcinoma component in lung adenocarcinoma.

作者信息

Lin D-M, Ma Y, Zheng S, Liu X-Y, Zou S-M, Wei W-Q

机构信息

Department of Pathology, Cancer Hospital/Institute, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

出版信息

Histol Histopathol. 2006 Jun;21(6):627-32. doi: 10.14670/HH-21.627.

DOI:10.14670/HH-21.627

PMID:16528673

Abstract

BAC is a common pattern in conventional lung adenocarcinoma. In the past, however, there were no well-defined criteria for BAC. As a result, it was difficult to evaluate the prognosis on this type of lung adenocarcinoma. Though the 1999 WHO classification of BAC provides a useful framework, it does not provide detailed enough information to predict prognosis in lung adenocarcinomas with BAC feature. The aim of this study was to address the prognostic value of bronchioloalveolar carcinoma (BAC) component in lung adenocarcinoma. Ninety-one consecutive surgically treated patients with adenocarcinoma exhibiting various degrees of BAC features and complete follow-up records were retrospectively studied. According to the percentage of BAC component designed as less than 50%, 50%-79%, 80%-99%, and 100%, tumors were classified as type I, type II, type III, and type IV respectively. The overall 5-year survival rate was 64.84%. Multivariate analysis revealed that the four classified types are independent prognostic factors (P=0.0008), as is tumor stage (P=0.0000). The 5-year survival rates were 39.29%, 58.82%, 81.25%, 85.71% for the four classified types respectively, and were 88.89% for stage I, 46.15% for stage II, and 23.81% for stage III. However, the size of tumor (>2 cm) was significant only in the univariate analysis (P=0.0275). In the patients with tumor size exceeding 2 cm in diameter, the BAC component was also significant to predict prognosis (p=0.0008). In lung adenocarcinoma, the BAC component may prove to be useful to predict the outcome of the patients, and the percentage of BAC pattern and pathological stage appear to be two independent prognostic factors.

摘要

细支气管肺泡癌（BAC）是传统肺腺癌中的一种常见模式。然而，过去对于BAC并没有明确的诊断标准。因此，很难评估这类肺腺癌的预后。虽然1999年世界卫生组织（WHO）对BAC的分类提供了一个有用的框架，但它并未提供足够详细的信息来预测具有BAC特征的肺腺癌的预后。本研究的目的是探讨肺腺癌中细支气管肺泡癌（BAC）成分的预后价值。我们回顾性研究了91例连续接受手术治疗的腺癌患者，这些患者具有不同程度的BAC特征且有完整随访记录。根据BAC成分所占百分比分为小于50%、50%-79%、80%-99%和100%，肿瘤分别被分类为I型、II型、III型和IV型。总体5年生存率为64.84%。多因素分析显示，这四种分类类型是独立的预后因素（P = 0.0008），肿瘤分期也是独立预后因素（P = 0.0000）。四种分类类型的5年生存率分别为39.29%、58.82%、81.25%、85.71%，I期为88.89%，II期为46.15%，III期为23.81%。然而，肿瘤大小（>2 cm）仅在单因素分析中有统计学意义（P = 0.0275）。在肿瘤直径超过2 cm的患者中，BAC成分对预测预后也具有统计学意义（P = 0.0008）。在肺腺癌中，BAC成分可能有助于预测患者的预后，BAC模式的百分比和病理分期似乎是两个独立的预后因素。