Wang Jie, Lu Charles, Liu Xu-yi, Zhang Hong-bing, Zhao Jun, Yang Lu, Guo Qing-zhi, An Tong-tong, Wu Mei-na
Department of Respiratory Medicine, Beijing University School of Oncology, Beijing Cancer Hospital, Beijing 100036, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2007 Feb;30(2):103-7.
In patients with resected early stage non-small cell lung cancer (NSCLC), intrapulmonary solitary tumor represents either second primary tumor (SPT) or a metastasis. This study is to discern SPT from lung metastasis in patients with postoperative NSCLC followed a solitary intrapulmonary tumor by microsatellite analysis.
Twenty-one patients with stage I - III(A) NSCLC resected by surgery during 1994.1 - 2002.8 were studied. Paired tumors from 21 patients with NSCLC and a solitary lung nodule were analyzed for their loss of heterozygosity (LOH) on chromosomal arms 3p, 9p and 17p. DNA from microdissected tumors and non-malignant lung tissues was subjected to polymerase chain reaction-based microsatellite analysis using 8 microsatellite markers. An effort was also made to distinguish SPT from lung metastasis on the basis of clinical and histopathologic features.
The paired tumors from 7 patients had concordant patterns of LOH at all microsatellite loci suggesting the same clonal origin, and supporting metastatic spread, where 4 paired tumors had discordant patterns of at all loci suggesting independent tumor origin. These observations were supported by the clinical and pathologic findings. Additional 6 paired tumors had concordant allelic loss on 3p and discordant loss on the other, clinical characteristics supporting metastatic disease. In contrast, 2 paired tumors had concordant allelic loss on 9p or 17p but discordant loss on the 3p, clinical data supporting SPT.
The paired tumors from 7 patients had concordant patterns of LOH at all microsatellite loci suggesting the same clonal origin, and supporting metastatic spread, where 4 paired tumors had discordant patterns of at all loci suggesting independent tumor origin. These observations were supported by the clinical and pathologic findings. Additional 6 paired tumors had concordant allelic loss on 3p and discordant loss on the other, clinical characteristics supporting metastatic disease. In contrast, 2 paired tumors had concordant allelic loss on 9p or 17p but discordant loss on the 3p, clinical data supporting SPT.
在接受手术切除的早期非小细胞肺癌（NSCLC）患者中，肺内孤立性肿瘤可能代表第二原发性肿瘤（SPT）或转移瘤。本研究旨在通过微卫星分析，在术后NSCLC且伴有肺内孤立性肿瘤的患者中鉴别SPT和肺转移瘤。
对1994年1月至2002年8月期间接受手术切除的21例I - III（A）期NSCLC患者进行研究。对21例NSCLC患者的配对肿瘤及一个孤立性肺结节进行分析，检测其染色体3p、9p和17p臂上的杂合性缺失（LOH）情况。从显微切割的肿瘤组织和非恶性肺组织中提取的DNA，使用8个微卫星标记进行基于聚合酶链反应的微卫星分析。同时，还根据临床和组织病理学特征来区分SPT和肺转移瘤。
7例患者的配对肿瘤在所有微卫星位点均有一致的LOH模式，提示克隆起源相同，支持转移扩散；其中4例配对肿瘤在所有位点的模式不一致，提示肿瘤起源独立。这些观察结果得到了临床和病理发现的支持。另外6例配对肿瘤在3p上有一致的等位基因缺失，而在其他位点不一致，临床特征支持转移性疾病。相反，2例配对肿瘤在9p或17p上有一致的等位基因缺失，但在3p上不一致，临床数据支持SPT。
7例患者的配对肿瘤在所有微卫星位点均有一致的LOH模式，提示克隆起源相同，支持转移扩散；其中4例配对肿瘤在所有位点的模式不一致，提示肿瘤起源独立。这些观察结果得到了临床和病理发现的支持。另外6例配对肿瘤在3p上有一致的等位基因缺失，而在其他位点不一致，临床特征支持转移性疾病。相反，2例配对肿瘤在9p或17p上有一致的等位基因缺失，但在3p上不一致，临床数据支持SPT。
