肺原位腺癌及微浸润性腺癌的临床特征及PD-L1表达的研究

发布时间：2018-03-15 18:11

本文选题：肺原位腺癌(AIS)　切入点：微浸润性腺癌(MIA)　出处：《浙江大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:根据IASLC/ATS/ERS 2011肺癌分类,肺腺癌有两种新的概念,肺原位腺癌(AIS)以及微浸润性腺癌(MIA),这两者均为肺腺癌的早期阶段。本研究旨在分析肺原位腺癌及微浸润性腺癌的临床特征以及程序性细胞死亡配体(PD-L1)的表达情况。材料与方法:本研究分析了 274例诊断为AIS或MIA患者的一些临床特征,例如年龄、性别、吸烟史、家族史、手术、EGFR突变、ALK及ROS-1免疫组化染色、血清CEA水平等。并分析了 17例AIS及37例MIA患者手术标本的PD-L1表达情况。若肿瘤组织经免疫组化染色超过5%肿瘤细胞被染色则视为PD-L1表达阳性。结果:在274名患者中,77名患者被诊断为AIS,197名被诊断为MIA。本研究中发现4名MIA患者复发。AIS及MIA患者被诊断时的中位年龄均为52岁,AIS中女性占71.4%,MIA中女性占71.1%。36.4%的AIS患者曾出现过症状,而在MIA为28.9%。AIS、MIA病人中分别有12.9%、8.6%有吸烟史。MIA患者中PD-L1均为阴性,仅有一例AIS患者PD-L1弱阳性。16.7%(5/30)的AIS存在术前CT肺结节微小进展,而MIA中为27.5%(14/51)。阳性症状与术前CT肺结节微小进展可能存在相关性。所有行淋巴结采样的患者均无淋巴结转移。结论:AIS与MIA之间临床特征无显著差异。诊断为AIS或MIA的患者中女性较男性多,尤其是不吸烟的女性。AIS及MIA均几乎不表达PD-L1,且无淋巴结转移。
[Abstract]:Objective: according to IASLC/ATS/ERS 2011 lung cancer classification, lung adenocarcinoma has two new concepts. The aim of this study was to analyze the clinical features and the expression of PD-L1) in pulmonary in situ adenocarcinoma and microinvasive adenocarcinoma. Materials and methods: the clinical features of 274 patients with AIS or MIA were analyzed. For example, age, sex, smoking history, family history, surgical EGFR mutation, ALK and ROS-1 immunohistochemical staining, The expression of PD-L1 in 17 cases of AIS and 37 cases of MIA were analyzed. If more than 5% tumor cells were stained by immunohistochemistry, the expression of PD-L1 was regarded as positive. In this study, we found that 4 patients with MIA recurred. AIS and MIA patients were diagnosed at the median age of 52 years. The median age of AIS was 71.4% of the 71. 4% of AIS patients who were diagnosed with AIS. Among the patients with MIA 28.9. AIS-MIA, 12.9% of them had smoking history. All the patients with MIA were negative for PD-L1. Only one case of AIS with PD-L1 weakly positive. 16.7% of MIA patients had slight progression of CT pulmonary nodules before operation. In MIA, 14 / 51 were 27. 5 / 51. The positive symptoms may be correlated with the small progression of CT pulmonary nodules before operation. All the patients who underwent lymph node sampling have no lymph node metastasis. Conclusion there is no significant difference in clinical characteristics between MIA and MIA. Diagnosis of AIS or MIA is not significant. More women than men, Especially in non-smoking women. AIS and MIA hardly expressed PD- L 1 and had no lymph node metastasis.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2

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