CAJ | 학술논문

目的：探讨肿瘤源性集落刺激因子1（ CSF1）在肺腺癌组织中的表达及其对预后的影响，并初步研究其可能的作用机制。方法采用免疫组化法检测266例肺腺癌患者组织芯片中CSF1、表皮生长因子受体（ EGFR）和CD68的表达水平。结果在266例肺腺癌患者中， CSF1、EGFR和CD68的阳性率分别为56．4％、42．1％和81．2％。 CSF1表达与肺腺癌患者的TNM分期、淋巴结阳性站数、肿瘤复发和EGFR表达有关（P＜0．05）。全组肺腺癌患者的5年生存率为41．4％，5年无瘤生存率为39．4％。单因素分析显示，TNM分期、淋巴结阳性数目、淋巴结阳性站数、CSF1表达、CSF1联合EGFR表达及CSF1、CD68和EGFR联合表达与肺腺癌患者的5年生存率有关（均P＜0．05）。多因素分析表明，TNM分期、CSF1联合EGFR表达及CSF1、CD68和EGFR联合表达为影响肺腺癌患者预后的独立因素（均 P＜0．05）。相关性分析表明， CSF1表达与 EGFR 表达呈正相关（P ＜0．001）， CSF1、EGFR表达分别与肿瘤相关巨噬细胞（TAMs）浸润情况呈正相关（P＜0．001，P＝0．008）。结论CSF1表达与肺腺癌患者的预后有关，CSF1和EGFR联合表达可作为肺腺癌患者术后独立的预测预后指标，其机制可能涉及癌细胞与TAMs的相互作用。
목적：탐토종류원성집락자격인자1（ CSF1）재폐선암조직중적표체급기대예후적영향，병초보연구기가능적작용궤제。방법채용면역조화법검측266례폐선암환자조직심편중CSF1、표피생장인자수체（ EGFR）화CD68적표체수평。결과재266례폐선암환자중， CSF1、EGFR화CD68적양성솔분별위56．4％、42．1％화81．2％。 CSF1표체여폐선암환자적TNM분기、림파결양성참수、종류복발화EGFR표체유관（P＜0．05）。전조폐선암환자적5년생존솔위41．4％，5년무류생존솔위39．4％。단인소분석현시，TNM분기、림파결양성수목、림파결양성참수、CSF1표체、CSF1연합EGFR표체급CSF1、CD68화EGFR연합표체여폐선암환자적5년생존솔유관（균P＜0．05）。다인소분석표명，TNM분기、CSF1연합EGFR표체급CSF1、CD68화EGFR연합표체위영향폐선암환자예후적독립인소（균 P＜0．05）。상관성분석표명， CSF1표체여 EGFR 표체정정상관（P ＜0．001）， CSF1、EGFR표체분별여종류상관거서세포（TAMs）침윤정황정정상관（P＜0．001，P＝0．008）。결론CSF1표체여폐선암환자적예후유관，CSF1화EGFR연합표체가작위폐선암환자술후독립적예측예후지표，기궤제가능섭급암세포여TAMs적상호작용。
Objective This study aimed to explore the expression of tumor?derived colony?stimulating factor 1 (CSF1), its prognostic significance and underlying related mechanisms in resected lung adenocarcinoma ( ADC ) . Methods Immunohistochemistry and tissue microarray were used to detect the expression of CSF1, epidermal growth factor receptor ( EGFR), and CD68 in 266 patients with lung adenocarcinoma treated in our department between 2004 and 2008. Results In the 266 ADC cases, the positive rates of expression of CSF1, EGFR and CD68 proteins were 56. 4%, 42. 1% and 81. 2%, respectively. The expression level of CSF1 was positively correlated with TNM stage, number of involved nodal stations, tumor recurrence and EGFR expression (P<0. 05). Univariate analysis indicated that TNM stage, number of involved lymph nodes, number of involved nodal stations, CSF1 expression, the combination of CSF1/EGFR and co?expression of CSF1/CD68/EGFR were statistically significant for prognosis (P<0. 05). The results of multivariate analysis showed that TNM stage, co?expression of CSF1/EGFR and CSF1/CD68/EGFR were significant and independent risk factors for survival (P <0. 05). Correlational analysis showed that expression of CSF1 and EGFR in the tumors was positively correlated to the degree of infiltration of interstitial tumor?associated macrophages (TAMs) (respectively; P <0. 05). Conclusions The expression of CSF1 indicates a poor prognosis in postoperative lung adenocarcinoma. Co?expression of CSF1 and EGFR may be a valuable independent prognostic predictor, and its mechanism is probably involved in the interaction of cancer cells and TAMs in the progression of lung adenocarcinoma.