Division of Thoracic Surgery, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
J Thorac Oncol. 2010 Jul;5(7):970-5. doi: 10.1097/JTO.0b013e3181dd1803.
Vascular invasion is thought to be a fundamental step in hematogenous metastasis. The aim of this study was to assess whether the qualitative evaluation of vascular invasion according to its location (intratumoral or extratumoral) could provide an appropriate means of predicting the prognostic outcome and potential patterns of recurrence in non-small cell lung cancer.
We reviewed the cases of 1000 consecutive patients in whom complete resection of non-small cell lung cancer had been performed. Sections stained by the Victoria blue van Gieson method were examined for the presence of vascular invasion and the evaluation of its location (v0: absence, n = 540; v1: intratumoral, n = 428; v2: extratumoral, n = 32). Survival was estimated using the Kaplan-Meier method. To determine independent prognostic factors, univariate and multivariate analyses were conducted.
The study cohort included 605 men and 395 women, with a mean age of 66 years (range, 20-90 years). The 5-year overall survival rate of the vascular invasion-negative group and the vascular invasion-positive group was 82.5% and 55.1%, respectively (p < 0.001), and the 5-year overall survival rates of the v1 group and v2 groups were 55.9% and 44.0%, respectively (p = 0.010). Multivariate analysis showed that location of the vascular invasion (v0-1 versus v2) (p = 0.049), age (p = 0.030), tumor size (p = 0.004), lymph node metastasis (p < 0.001), and pleural invasion (p < 0.001) were significant prognostic factors. The proportion of patients who developed distant metastasis was significantly higher in the v2 group than in the v1 group (p = 0.026).
Evaluation of vascular invasion location was a statistically significant predictor of prognosis and potential recurrence patterns.
血管侵犯被认为是血行转移的一个基本步骤。本研究旨在评估根据其位置（肿瘤内或肿瘤外）对血管侵犯进行定性评估是否可以为非小细胞肺癌的预后结果和潜在复发模式提供适当的预测手段。
我们回顾了 1000 例连续接受非小细胞肺癌完全切除术患者的病例。使用维多利亚蓝范古森法染色的切片检查血管侵犯的存在及其位置的评估（v0：无，n=540；v1：肿瘤内，n=428；v2：肿瘤外，n=32）。使用 Kaplan-Meier 方法估计生存情况。为了确定独立的预后因素，进行了单因素和多因素分析。
研究队列包括 605 名男性和 395 名女性，平均年龄为 66 岁（范围，20-90 岁）。血管侵犯阴性组和阳性组的 5 年总生存率分别为 82.5%和 55.1%（p<0.001），v1 组和 v2 组的 5 年总生存率分别为 55.9%和 44.0%（p=0.010）。多因素分析显示，血管侵犯的位置（v0-1 与 v2）（p=0.049）、年龄（p=0.030）、肿瘤大小（p=0.004）、淋巴结转移（p<0.001）和胸膜侵犯（p<0.001）是显著的预后因素。v2 组患者远处转移的比例明显高于 v1 组（p=0.026）。
评估血管侵犯的位置是预测预后和潜在复发模式的统计学上显著的预测指标。
