金沢大学医学部附属病院
FISH法を用いて肺癌患者の染色体異常の解析を行い,生物学的悪性度の各指標,臨床背景因子と比較検討し臨床応用の可能性を評価した.【対象】原発性非小細胞肺癌切除例74例を対象とした.男58例,女16例,平均年齢65歳であった.組織型は腺癌40例,扁平上皮癌34例,病期はI期19例,II期11例,IIIA期22例,IIIB期7例,IV期15例であった.【方法】次の項目を測定した.1.FISHによる第17番染色体数の測定.2.p53の免疫組織染色.3.PCNAの免疫組織染色.4.フローサイトメトリーによる核DNA量の測定.【結果】1.p53蛋白発現例は74例中37例(50%)で,扁平上皮癌,病期進行例,TNM各因子進行例,aneuploid症例で有意に多かった.2.PCNA高値群は74例中35例(47.3%)で,扁平上皮癌,低分化度症例,病期進行例,T因子進行例,CEA値高値例,aneuploid症例で有意に多かった.3.第17番染色体異常は74例中22例(29.7%)に認めた(CCN1,7例; CCN1and3,15例).4.CCN1and3は,病期,T因子,N因子,組織型,p53蛋白発現,PCNA標識率,生存率の各因子と有意な関連を認めた.5.CCN1はM因子と,CCN3は病期,N因子,組織型,p53蛋白発現,PCNA標識率の各因子と有意な関連を認めた.6.FITC spots meanは,病期およびN因子と有意な関連を認めた.7.CCN2の予後(5生率31.4%)はCCN1and3(同4.9)に比べ有意に良好であった.Aneuploid症例でもCCN2の予後(5生率30.8%)はCCN1and3(同5.0%)に比べ有意に良好であった.【まとめ】肺癌において染色体構造異常,癌遺伝子および細胞増殖能を比較検討することにより肺癌の進展,悪性度がより明確となり,今後治療法にも直結していく可能性が示唆された.
Objective ; We analyzed the chromosomal abnormalities in primary lung cancer cells and compared them with biological parameters of malignancy and a clinical background. Materials ; This study included 74 cases of primary non-small cell lung cancer resected at Kanazawa University Hospital between 1986-1989. Fifty-eight were male and 16 were female, and the mean age was 64.7 years. According to the TNM classification 19 were in stage I and 11,22,7,15 cases were in stage II,IIIA,IIIB,IV respectively. Methods ; We performed as follows. 1) The count of the chromosome 17 by FISH.2) The immunohistochemical staining against p53 protein. 3) The immunohistochemical staining against PCNA.4) The measurement of nuclear DNA contents by flowcytometry. Results ; 1) p53 protein expression was noted in 37 cases (50%) and observed significantly more frequently in cases of squamous cell carcinoma, cases with advanced disease and cases with DNA aneuploidy. 2) High level of PCNA was noted in 35 cases (47.3%) and observed significantly more frequently in cases of squamous cell carcinoma, cases of poorly differentiated type, cases with advanced disease, cases with advanced T factor, cases with high CEA level and cases with DNA aneuploidy. 3) Abnormalities of the chromosome 17 were noticed in 22 cases (29.7%). 7 cases were monosomy (CCN1) and 15 were trisomy (CCN3). 4) The significant difference was noticed in the pathological stage, the T factor, the N factor, the histological type, the expression of p53 protein, the PCNA labeling index and the survival rate comparing CCN1 and CCN3 with CCN2.5) There was significant difference in the M factor comparing CCN1 with others, and in the pathological stage, the N factor, the histological type, the expression of p53 protein and PCNA labelling index comparing CCN3 with others. 6) There was significant correlation between FITC spots mean and the pathological stage, the N factor. 7) The prognosis was significantly better in patients with CCN2 than in those with CCN1 and CCN3 (5-year survival rate : 31.4% vs 4.9% respectively). In cases with DNA aneuploidy, the same result was obtained (5-year survival rate : 30.8% vs 5.0%). Conclusions ; Investigation and comparision of chromosomal abnormalities, oncogenes and proliferating potential clarify the degree of progression and malignancy in lung cancer. They should be taken account into when predicting the survival and deciding the treatment.
研究課題/領域番号:07671456, 研究期間(年度):1995 – 1996
出典：研究課題「FISHによる原発性肺癌の染色体数異常の基礎的ならびに臨床的研究」課題番号07671456（KAKEN：科学研究費助成事業データベース（国立情報学研究所）） （https://kaken.nii.ac.jp/ja/report/KAKENHI-PROJECT-07671456/076714561996kenkyu_seika_hokoku_gaiyo/）を加工して作成