摘要
目的探讨Ⅰ期非小细胞肺癌(NSCLC)环氧化酶2(COX-2)、P53、Ki67、EGFR、HER2等基因表达与淋巴结微转移的关系及其预后价值。方法以S-P免疫组化法检测40例Ⅰ期NSCLC根治术后病灶COX-2、P53、Ki67、EGFR、HER2蛋白表达,以细胞角蛋白为指标检测86枚肺门淋巴结微转移状态。以Kaplan-Meier和Log rank检验进行5年生存资料分析,COX比例风险回归模型进行多因素预后分析。结果淋巴结微转移检出率16.3%(14/86)、患者阳性率为12.5%(5/40)。肺腺癌COX-2蛋白表达高于肺鳞癌及其他类型肺癌(P<0.05);其他基因表达在不同的性别、年龄、原发肿瘤大小、组织学分化程度、组织学类型、淋巴结微转移之间差异均无统计学意义(P>0.05)。组织学呈高分化、原发灶COX-2、P53蛋白阴性表达、淋巴结微转移阴性者5年生存率高(分别为78.6%,76.5%,73.7%,60.0%)。多因素COX比例风险回归分析显示:组织学分化程度、COX-2、P53蛋白表达是影响Ⅰ期NSCLC的独立预后因素。结论原发灶组织学分化程度、COX-2、P53蛋白表达是Ⅰ期NSCLC的独立预后因素。
Objective To study the relationship between COX-2, P53, KJ67, EGFR, HER2 expressions in primary tumor and micrometasta- sis in hilar lymph node and the prognosis for stage Ⅰ NSCLC. Methods Detecting COX-2, P53, Ki67, EGFR, HER2 protein expressions in primary tumor and cytokeratins expression, as a micrometastasis marker, in 86 hilar lymph nodes of 40 patients with completely resected stage I NSCLC by using S-P immunohistochemical staining. Kaplan-Meier method and Log rank test were used to analyze the 5-year survival. Multivariate Cox regression analysis was carried out for the prognosis. Results The positive rate of hilar lymph node micrometastasis was 16.3% （14/86） and 12.5% （5/40） for the positive cases. COX-2 expression in adenoearcinoma was higher than that of squamous and other types of lung cancer （ P 〈 0.05 ）.Other gene expressions were not related to ehnical pathologic characteristics such as gender, age, tumor size, differeneiation, histologie-type and lymph node nfierometastasis（ P 〉 0.05 ）.The 5-year survival rates were higher for patients with well-differentiated, negtive expression of COX-2, P53 or those without lymph node micrometastasis（ 78.57%, 76.47%, 73.68%, 60% ）. The grade of differentiation and the protein expressions of COX-2, P53 were identified as independent prognostic factors for stage I NSCLC by mutivariate Cox regression analysis. Conclusion The histologic differentiation and the protein expressions of COX-2, P53 in primary tumor were independent prognostic factors for stage Ⅰ NSCLC.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2011年第11期1026-1031,共6页
Journal of China Medical University
基金
辽宁省科技攻关及国际合作课题资助项目(20022250015
2009225011)
