發(fā)布時(shí)間：2018-03-15 18:11

  本文選題：肺原位腺癌(AIS)　切入點(diǎn)：微浸潤(rùn)性腺癌(MIA)　出處：《浙江大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:根據(jù)IASLC/ATS/ERS 2011肺癌分類,肺腺癌有兩種新的概念,肺原位腺癌(AIS)以及微浸潤(rùn)性腺癌(MIA),這兩者均為肺腺癌的早期階段。本研究旨在分析肺原位腺癌及微浸潤(rùn)性腺癌的臨床特征以及程序性細(xì)胞死亡配體(PD-L1)的表達(dá)情況。材料與方法:本研究分析了 274例診斷為AIS或MIA患者的一些臨床特征,例如年齡、性別、吸煙史、家族史、手術(shù)、EGFR突變、ALK及ROS-1免疫組化染色、血清CEA水平等。并分析了 17例AIS及37例MIA患者手術(shù)標(biāo)本的PD-L1表達(dá)情況。若腫瘤組織經(jīng)免疫組化染色超過(guò)5%腫瘤細(xì)胞被染色則視為PD-L1表達(dá)陽(yáng)性。結(jié)果:在274名患者中,77名患者被診斷為AIS,197名被診斷為MIA。本研究中發(fā)現(xiàn)4名MIA患者復(fù)發(fā)。AIS及MIA患者被診斷時(shí)的中位年齡均為52歲,AIS中女性占71.4%,MIA中女性占71.1%。36.4%的AIS患者曾出現(xiàn)過(guò)癥狀,而在MIA為28.9%。AIS、MIA病人中分別有12.9%、8.6%有吸煙史。MIA患者中PD-L1均為陰性,僅有一例AIS患者PD-L1弱陽(yáng)性。16.7%(5/30)的AIS存在術(shù)前CT肺結(jié)節(jié)微小進(jìn)展,而MIA中為27.5%(14/51)。陽(yáng)性癥狀與術(shù)前CT肺結(jié)節(jié)微小進(jìn)展可能存在相關(guān)性。所有行淋巴結(jié)采樣的患者均無(wú)淋巴結(jié)轉(zhuǎn)移。結(jié)論:AIS與MIA之間臨床特征無(wú)顯著差異。診斷為AIS或MIA的患者中女性較男性多,尤其是不吸煙的女性。AIS及MIA均幾乎不表達(dá)PD-L1,且無(wú)淋巴結(jié)轉(zhuǎn)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.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R734.2

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