| Objective:To study the clinic characteristics and prognostic factors ofⅢa (N2) NSCLC.Furthermore,to evaluate the expression and clinical significance of adenomateous polyposis coli gene(APC),excision repair cross-comp lementing 1 (ERCC1),cytokeratin 19(CK 19),and investigate the value of these factors in identification of the prognosis in order to provide evidence for clinical therapy.Method:Clinic data of 49 inpatient cases in The Cancer Hospital of Tianjin Medical University,from 2000.1.1-2003.12.31,were retrospectively reviewed. Expression of APC,ERCC1 and CK19 that were surgically resected NSCLC specimens was studied by immunohistochemistry.The value of the three factors in identification of the prognosis was examined by survival analysis.Result:1.Result of clinical dataThe overall 1,3 and 5-year survival rates were 79.59%,30.61%,12.24% respectively.The main prognostic factors weretumor diameter,positive of stump,Tstage,if singale station of mediastinal lymph node metastasis(yes/not) and immunotherapy(P＜0.05).Gender,age(≥60 or＜60 years),somking,pathology type,if N1 metastasis,radiotherapy were not significant prognostic factors(P＞0.05).Cox regression analysis suggested that the tumor diameter(P=0.039) and if singale station of mediastinal lymph node metastasis(yes/not)(P=0.047) are independent factors affecting the prognosis.2 The expression of APC,ERCC1 and CK19 inⅢa(N2) NSCLC and their significancesAll the APC,ERCC1 and CK19 has positive result in this experiment.The positive rate of APC,ERCC1 and CK 19 are 30.61%,38.78%and 42.76%.The positive rate of APC was significantly higher in women patients than that in men (P=0.015),and higher in adenocarcinoma than squamous carcinoma.The positive rate of CK19 was significantly higher in patients with multude station of mediastinal lymph node metastasis(p=0.031),and patients with N1 metastasis(p=0.011).The positive rate of ERCC 1 was significantly higher in the patients with more than 3cm diameter tumor(p=0.015).The different expression of ERCC1 has statistical significance to the prognosis((P＜0.05).Cox Regression suggested that ERCC1, tumor diameter and if singale station of mediastinal lymph node metastasis(yes/not) were independent factors affecting the prognosis of idencialⅢa NSCLC..Conclusion:IdencialⅢa NSCLC is an special type of N2 stage NSCLC that has a special biological behaviour,as well as a special clinical,radiological and pathological presentation.The overall survival rate of IdencialⅢa patients was superior to those with clinical N2(NSCLC).The expression of APC,ERCC1 and CK19 has a higher specificity.ERCC1,tumor diameter and if singale station of mediastinal lymph node metastasis(yes/not) were independent factors. |
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