CAJ | 학술논문

目的探讨肝细胞膜表面相关抗原(HAb18G)表达与非小细胞肺癌的侵袭、转移及预后的关系.方法用免疫组织化学SP法检测144例非小细胞肺癌组织、19例肺良性病变和41例正常肺组织中HAb18G蛋白的表达,用图像分析软件对HAb18G蛋白表达的阳性单位(PU)进行定量测试.结果 HAb18G在非小细胞肺癌组织中的表达主要定位于肺癌细胞膜或胞质,其在肺良性病变及正常肺组织中几乎不表达.在非小细胞肺癌患者中,25例低表达(17.4％),119例高表达(82.6％)；59例膜表达为主(41.0％),81例胞质表达为主(56.3％),4例无阳性着色(2.8％).HAb18G蛋白表达的PU值在非小细胞肺癌组织中显著高于非肺癌肺组织(P=0.000)；高分化肺鳞癌和腺癌低于中至低分化肺鳞癌和腺癌(P=0.001)；HAb18G蛋白在TNM Ⅰ期、Ⅱ～Ⅲ期、Ⅳ期中依次升高(P=0.000),非小细胞肺癌伴淋巴结转移的原发灶高于无转移的原发灶(P =0.045)；蛋白PU值在最大直径＞5 cm的非小细胞肺癌组织中的表达大于最大直径≤5 cm的肺癌组织(P=0.000),男性患者高于女性患者(P=0.046),与非小细胞肺癌患者年龄、吸烟史、大体类型及原发灶和相应转移灶的情况均无关(P＞0.05).HAb18G低表达患者的5年生存率大于HAb18G高表达患者(P=0.006)；单因素分析结果表明HAb18G高表达的非小细胞肺癌患者预后差(P=0.007)；Cox分析结果显示HAb18G表达是非小细胞肺癌患者的独立预后因素(P=0.032,相对危险度为3.962).结论 HAb18G蛋白在肺癌组织中的表达与非小细胞肺癌的发生发展、浸润转移和预后密切相关,可作为预测浸润转移和估计预后的一个参考指标.
목적 탐토간세포막표면상관항원(HAb18G)표체여비소세포폐암적침습、전이급예후적관계.방법 용면역조직화학SP법검측144례비소세포폐암조직、19례폐량성병변화41례정상폐조직중HAb18G단백적표체,용도상분석연건대HAb18G단백표체적양성단위(PU)진행정량측시.결과 HAb18G재비소세포폐암조직중적표체주요정위우폐암세포막혹포질,기재폐량성병변급정상폐조직중궤호불표체.재비소세포폐암환자중,25례저표체(17.4％),119례고표체(82.6％)；59례막표체위주(41.0％),81례포질표체위주(56.3％),4례무양성착색(2.8％).HAb18G단백표체적PU치재비소세포폐암조직중현저고우비폐암폐조직(P=0.000)；고분화폐린암화선암저우중지저분화폐린암화선암(P=0.001)；HAb18G단백재TNM Ⅰ기、Ⅱ～Ⅲ기、Ⅳ기중의차승고(P=0.000),비소세포폐암반림파결전이적원발조고우무전이적원발조(P =0.045)；단백PU치재최대직경＞5 cm적비소세포폐암조직중적표체대우최대직경≤5 cm적폐암조직(P=0.000),남성환자고우녀성환자(P=0.046),여비소세포폐암환자년령、흡연사、대체류형급원발조화상응전이조적정황균무관(P＞0.05).HAb18G저표체환자적5년생존솔대우HAb18G고표체환자(P=0.006)；단인소분석결과표명HAb18G고표체적비소세포폐암환자예후차(P=0.007)；Cox분석결과현시HAb18G표체시비소세포폐암환자적독립예후인소(P=0.032,상대위험도위3.962).결론 HAb18G단백재폐암조직중적표체여비소세포폐암적발생발전、침윤전이화예후밀절상관,가작위예측침윤전이화고계예후적일개삼고지표.
Objective To study the association between HAb18G expression,tumor parameters,metastatic potential and prognosis in non-small cell lung carcinoma ( NSCLC ). Methods Immunohistochemical study for HAb18G protein using SP methods was carried out in 144 cases of NSCLC.Nineteen cases of benign lung lesions and 41 cases of normal lung tissue were used as controls.The intensity (positive unit/PU) of HAb18G expression was assessed quantitatively by image analysis software.The results were correlated with tumor parameters,metastatic potential and follow-up data. Results The intensity of HAb18G protein expression was significantly higher in NSCLC than that in controls (P=0.000).In squamous cell carcinomas and adenocarcinomas,the expression of HAb18G protein in well-differentiated tumors was lower than that in moderately to poorly differentiated tumors ( P =0.001 ).Tumors of TNM stage IV had stronger expression than tumors of lower stages ( P =0.000).HAb18G PU was greater in tumors with lymph node metastasis than those without nodal metastasis ( P =0.045 ).The PU value of tumors with maximal diameter greater than 5 cm was higher than that of the smaller tumors (P =0.000).It was also higher in male than in female patients ( P =0.046 ).There was no association between HAb18G protein expression and age of patients,history of smoking,tumor types and gross morphology (P ＞ 0.05 ).The five-year survival rate in cases with low HAb1 8G protein expression was higher than that in cases with high expression ( P =0.006).Univariate analysis indicated that patients with high HAb18G protein expression carried a poor prognosis ( P =0.007 ). Multivariate analysis showed that expression of HAb18G protein was an independent prognostic factor in patients with NSCLC ( P =0.032,relative risk 3.962).Conclusions HAb18G protein expression is associated with tumor progression and prognosis.It may represent a useful biomarker for prognostic evaluation.