Bréchot J M, Chevret S, Charpentier M C, Appere de Vecchi C, Capron F, Prudent J, Rochemaure J, Chastang C
Service de Pneumologie, Hôtel-Dieu, Paris, France.
Cancer. 1996 Nov 15;78(10):2111-8.
The objective of this prospective study was to assess in 96 patients with resected nonsmall cell lung carcinoma (NSCLC) the prevalence of both blood and lymphatic vessel invasion (BVI and LVI) according to stage, as well as their prognostic value for disease free and overall survival.
BVI and LVI were evaluated by hematoxylin and eosin stains on surgical specimens after resection. Associations among variables were tested by Fisher's exact test or the chi-square test; prognostic values on time-failure data were analyzed by the log rank test and the multivariate Cox model.
BVI was present in 52% of NSCLC cases and LVI in 59%. Venous but not arterial vascular invasion correlated with the T factor and pTNM, whereas LVI correlated with the N factor and pTNM. In univariate analysis, LVI but not BVI was associated with a short disease free interval (P = 0.0007) and poor survival (P = 0.0001). The estimated relative risk of death in patients with LVI was 3.2 compared with patients without LVI. In multivariate analysis, LVI and pTNM were additional predictors for poor disease free and overall survival. In this series, BVI had no prognostic value.
The prevalence of BVI and LVI appeared high in patients with NSCLC, especially those with advanced pTNM stages. LVI was predictive of poor outcome, both time to recurrence and death.
本前瞻性研究的目的是评估96例接受手术切除的非小细胞肺癌（NSCLC）患者中，根据分期的血管和淋巴管侵犯（BVI和LVI）的发生率，以及它们对无病生存期和总生存期的预后价值。
通过苏木精-伊红染色评估切除术后手术标本中的BVI和LVI。变量之间的关联通过Fisher精确检验或卡方检验进行；对时间-失败数据的预后价值通过对数秩检验和多变量Cox模型进行分析。
52%的NSCLC病例存在BVI，59%存在LVI。静脉而非动脉血管侵犯与T因子和pTNM相关，而LVI与N因子和pTNM相关。在单变量分析中，LVI而非BVI与无病间期缩短（P = 0.0007）和生存率低（P = 0.0001）相关。与无LVI的患者相比，有LVI的患者估计死亡相对风险为3.2。在多变量分析中，LVI和pTNM是无病生存期和总生存期差的额外预测因素。在本系列中，BVI没有预后价值。
NSCLC患者中BVI和LVI的发生率似乎很高，尤其是那些pTNM分期较晚的患者。LVI可预测复发时间和死亡的不良结局。
