CAJ | 학술논문

背景与目的肺腺癌是最常见的肺癌组织学类型，发病率呈上升趋势。本研究旨在探讨Napsin A、TTF-1、ERCC1、RRM1、EGFR、HER2、ERα、ERβ、PR、Bcl-2蛋白在肺腺癌中的表达及与临床病理特征和预后的关系。方法将227例肺腺癌石蜡标本构建组织芯片。采用免疫组化方法检测10种靶蛋白标记物在肺腺癌中的表达，分析各蛋白表达与患者临床病理特征和预后的关系。结果10种蛋白中仅Napsin A蛋白表达与性别有关（P=0.049）；Napsin A、PR和EGFR蛋白表达与吸烟有关，TTF-1和ERCC1蛋白表达与肿瘤大小有关，Napsin A、TTF-1、ERα和PR蛋白表达与肿瘤分化程度有关，TTF-1、Bcl-2和ERCC1蛋白表达与病理分期有关（P<0.05）。10种蛋白表达均与年龄无关，ERβ、HER2和RRM1蛋白表达与各项临床病理参数均无相关性（P>0.05）。单因素生存分析显示，Napsin A、TTF-1和ERCC1蛋白表达与患者总生存相关；TTF-1蛋白表达与患者无病生存相关（P<0.05）。进一步分析I期肺腺癌，仅Napsin A蛋白表达与患者总生存相关，P<0.05；10种蛋白表达均与I期患者无病生存无关（P>0.05）。经多因素生存分析，仅病理分期与患者总生存和无病生存相关（P<0.05）；10种蛋白表达均未显示与患者生存的相关（P>0.05）。结论 Napsin A、TTF-1和ERCC1蛋白可能是提示肺腺癌患者预后较好的标记物。
배경여목적폐선암시최상견적폐암조직학류형，발병솔정상승추세。본연구지재탐토Napsin A、TTF-1、ERCC1、RRM1、EGFR、HER2、ERα、ERβ、PR、Bcl-2단백재폐선암중적표체급여림상병리특정화예후적관계。방법장227례폐선암석사표본구건조직심편。채용면역조화방법검측10충파단백표기물재폐선암중적표체，분석각단백표체여환자림상병리특정화예후적관계。결과10충단백중부Napsin A단백표체여성별유관（P=0.049）；Napsin A、PR화EGFR단백표체여흡연유관，TTF-1화ERCC1단백표체여종류대소유관，Napsin A、TTF-1、ERα화PR단백표체여종류분화정도유관，TTF-1、Bcl-2화ERCC1단백표체여병리분기유관（P<0.05）。10충단백표체균여년령무관，ERβ、HER2화RRM1단백표체여각항림상병리삼수균무상관성（P>0.05）。단인소생존분석현시，Napsin A、TTF-1화ERCC1단백표체여환자총생존상관；TTF-1단백표체여환자무병생존상관（P<0.05）。진일보분석I기폐선암，부Napsin A단백표체여환자총생존상관，P<0.05；10충단백표체균여I기환자무병생존무관（P>0.05）。경다인소생존분석，부병리분기여환자총생존화무병생존상관（P<0.05）；10충단백표체균미현시여환자생존적상관（P>0.05）。결론 Napsin A、TTF-1화ERCC1단백가능시제시폐선암환자예후교호적표기물。
Background and objective Lung adenocarcinoma is one of the most common histological subtypes of lung cancer. hTe incidence of this disease was continuously increased. hTis study aims to detect the expressions of Napsin A, TTF-1, ERCC1, RRM1, EGFR, HER2, ERα, ERβ, PR, and Bcl-2 in lung adenocarcinoma and to explore their correlations with clinicopathological characteristics and prognosis. Methods A total of 227 lung adenocarcinoma specimens were constructed in tissue microarrays. The expressions of the 10 tumor biomarkers were analyzed by immunohistochemistry on paraffin-embedded sections. Results Among the 10 markers, Napsin A was gender-related (P=0.049). Napsin A, PR, and EGFR were signiifcantly associated with smoking. TTF-1 and ERCC1 were closely associated with tumor size. Napsin A, TTF-1, ERα, and PR were remarkably associated with tumor differentiation. TTF-1, Bcl-2, and ERCC1 were closely associated with tumor stage (P<0.05). No marker was related to age. No correlations were observed between ERβ, HER2, and RRM1 expressions and clini-copathological parameters (P>0.05). Univariate analysis results showed that Napsin A, TTF-1, and ERCC1 were signiifcantly associated with overall survival. TTF-1 was remarkably associated with disease-free survival (P<0.05). Stage I cases were further analyzed and revealed that only Napsin A expression was associated with overall survival (P<0.05). No marker was correlated with disease-free survival (P>0.05). Multivariate analysis results showed that pathological staging was signiifcantly associated with overall survival and disease-free survival (P<0.05). No marker was identiifed as a predictor of patient outcome (P>0.05). Conclusion Napsin A, TTF-1, and ERCC1 are the markers indicating good prognosis of lung adenocarcinoma.