Zimmerman P V, Hawson G A, Bint M H, Parsons P G
Lancet. 1987 Sep 5;2(8558):530-3. doi: 10.1016/s0140-6736(87)92923-0.
The usefulness of tumour ploidy as a prognostic determinant in lung cancer was evaluated in a group of 100 surgically treated patients. Archival paraffin sections of the tumours were analysed by flow cytometry. 45% of tumours were aneuploid and 55% were diploid. Overall, patients with aneuploid tumours had significantly shorter survival (p less than 0.0005) than those with diploid tumours. The subset of patients without nodal involvement at operation and with diploid tumours had a particularly long survival rate. Of these 45 patients 41 (91%) were alive at 2 years compared with only 16 (55%) of the 29 with aneuploid tumours (p less than 0.05). A group with such a favourable prognosis has not previously been recognised except when staging is based on total mediastinal nodal clearance. Ploidy was found to be independent of age, sex, type of operation, site of primary tumour, histology, or TNM category. On Cox multivariate analysis ploidy was the most important and independent prognostic determinant. Therefore, in patients with operable lung cancer, ploidy should be taken into account in planning of management, in estimation of prognosis, and in stratification for treatment trials.
在一组100例接受手术治疗的肺癌患者中，评估了肿瘤倍体作为预后决定因素的有用性。通过流式细胞术分析肿瘤的存档石蜡切片。45%的肿瘤为非整倍体，55%为二倍体。总体而言，非整倍体肿瘤患者的生存期明显短于二倍体肿瘤患者（p小于0.0005）。手术时无淋巴结受累且肿瘤为二倍体的患者亚组生存期特别长。在这45例患者中，41例（91%）在2年时存活，而29例非整倍体肿瘤患者中只有16例（55%）存活（p小于0.05）。除了基于全纵隔淋巴结清扫进行分期外，此前尚未认识到有如此良好预后的一组患者。发现倍体与年龄、性别、手术类型、原发肿瘤部位、组织学或TNM分类无关。在Cox多变量分析中，倍体是最重要且独立的预后决定因素。因此，对于可手术的肺癌患者，在制定治疗计划、评估预后以及进行治疗试验分层时，应考虑倍体情况。
