细胞角蛋白及波形蛋白在原发性肺肉瘤样癌中的诊断价值及其与临床预后的关系

陶慧峰; 吴庆国; 张晓林; 潘磊; 李锋

doi:10.7619/jcmp.202008010

细胞角蛋白及波形蛋白在原发性肺肉瘤样癌中的诊断价值及其与临床预后的关系

上海市公共卫生临床中心呼吸科, 上海, 201508

基金项目:

国家科技重大专项项目(2017ZX10305501-008)

详细信息

通讯作者:
李锋,E-mail:lifeng@shphc.org.cn

中图分类号: R734.2
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出版历程
- 收稿日期: 2020-01-12

Values of cytokeratin and Vimentin in diagnosing primary pulmonary sarcomatoid carcinoma and their correlations with clinical prognosis

Department of Respiratory, Shanghai Public Health Clinical Center, Shanghai, 201508

摘要

摘要: 目的探讨细胞角蛋白(CK)及波形蛋白(Vimentin)在原发性肺肉瘤样癌(PSC)中的诊断价值及其与临床预后的关系。方法选取139例疑似PSC患者为研究组,选取同期30名健康人肺组织标本作为对照组。采用免疫组化法检测肿瘤组织与正常肺组织中CK及Vimentin表达水平。以术后病理诊断为PSC金标准,采用受试者工作曲线(ROC)计算CK及Vimentin诊断PSC的灵敏度、特异性、曲线下面积(AUC)和95%置信区间(95%CI)。对所有PSC患者随访3年,观察PSC患者3年存活率,并采用Cox比例风险回归模型进行多因素分析。结果 139例疑似PSC患者经术后病理诊断确诊132例, 7例为小细胞肺癌。研究组CK及Vimentin阳性表达率分别为95.68%和97.84%, 对照组CK及Vimentin无阳性表现,差异有统计学意义(P<0.05)。ROC显示, CK诊断PSC的灵敏度、特异性、AUC和95%CI分别为0.985、0.904、0.952和0.899~1.000, Vimentin诊断PSC的灵敏度、特异性、AUC和95%CI分别为1.000、0.919、0.959和0.908~1.000。132例PSC患者1、3年生存率分别为81.06%和56.06%。Cox风险模型分析显示,肿瘤大小、远处转移、CK和Vimentin阳性表达是影响患者3年生存率的风险因素(P<0.05)。结论 CK和Vimentin在PSC诊断和预后评估中均有一定的临床价值。
- 原发性肺肉瘤样癌 /
- 细胞角蛋白 /
- 波形蛋白 /
- 诊断价值 /
- 预后
Abstract: Objective To investigate the value of cytokeratin(CK)and Vimentin in diagnosing primary pulmonary sarcomatoid carcinoma(PSC)and their correlations with clinical prognosis. Methods A total of 139 patients with suspected PSC were selected as study group, and samples of normal lung tissues of 30 healthy people were collected as control group. Immunohistochemistry was used to detect the expressions of CK and Vimentin in tumor tissues and normal lung tissues. The postoperative pathological diagnosis was considered as gold standard for PSC, and the sensitivity, specificity, the area under curve(AUC)and 95% confidence interval(95%CI)of CK and Vimentin in the diagnosis of PSC were calculated by the receiver operating curve(ROC). All the patients with PSC were followed up for 3 years, and the 3-year survival rate was observed. Multivariate analysis was carried out by using Cox proportional risk regression model. Results Of the 139 patients with suspected PSC, 132 cases were confirmed by pathological results, and 7 cases were diagnosed as small cell lung cancer. The positive expression rates of CK and Vimentin in the study group were 95.68% and 97.84% respectively, but there was no case with positive expressions of CK and Vimentin in the control group, and there were significant differences in positive expression rates of CK and Vimentin between two groups(P<0.05). ROC showed that the sensitivity, specificity, AUC and 95%CI of CK for diagnosis of PSC were 0.985, 0.904, 0.952 and 0.899 to 1.000 respectively, while those of Vimentin - for diagnosis of PSC were 1.000, 0.919, 0.959 and 0.908 to 1.000 respectively. The 1-year and 3-year survival rates of 132 patients with PSC were 81.06% and 56.06% respectively. Cox risk model analysis showed that tumor size, distant metastasis, positive expressions of CK and Vimentin were risk factors affecting the 3-year survival rate of patients(P<0.05). Conclusion CK and Vimentin have certain clinical values in the diagnosis and prognosis evaluation of PSC.
- primary pulmonary sarcomatoid carcinoma /
- cytokeratin /
- Vimentin /
- diagnostic value /
- prognosis

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施引文献(3)

期刊类型引用(2)

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2.	惠灿灿，孙艳，吴庆彬，汪艳丽，王芬. 甲状腺肉瘤样癌1例报道. 中国医药导报. 2022(12): 181-184 . 百度学术