CAJ | 학술논문

背景：肺腺癌干细胞是肺腺癌确诊的重要实验室依据，但其评估患者预后的价值如何，临床尚未定论。目的：探讨人肺腺癌干细胞表型与患者预后的关系。方法：选取2010年2月至2013年1月在新疆医科大学第一附属医院治疗的肺腺癌患者48例，采用免疫荧光法检测患者肺腺癌干细胞表型标志，比较不同表型与患者临床病例特征以及患者预后的关系。结果与结论：48例肺腺癌组织中均观察到SP-C表达和CCSP表达，具有肺细支气管肺泡干细胞的表型特征，其中34例同时表达OCT4(OCT4+支气管肺泡干细胞组)，14例不表达OCT4(OCT4-支气管肺泡干细胞组)。OCT4+支气管肺泡干细胞组和OCT4-支气管肺泡干细胞组肺腺癌患者的年龄、性别、吸烟史以及肿瘤分期差异无显著性意义(P >0.05)；OCT4+支气管肺泡干细胞组有23例(68%)患者癌细胞转移，明显高于OCT4-支气管肺泡干细胞组(21%)，差异有显著性意义(P <0.05)；在腺癌患者年龄、性别、吸烟史、分期以及癌细胞转移等临床病理特征分层中，OCT4-支气管肺泡干细胞组肺腺癌2年生存率普遍高于OCT4+支气管肺泡干细胞组，两组生存曲线差异有显著性意义(P <0.05)。结果表明人肺腺癌干细胞具有肺细支气管肺泡干细胞表型特征，同时表达胚胎干细胞基因OCT4时，患者预后差，与肺腺癌转移有关。
배경：폐선암간세포시폐선암학진적중요실험실의거，단기평고환자예후적개치여하，림상상미정론。목적：탐토인폐선암간세포표형여환자예후적관계。방법：선취2010년2월지2013년1월재신강의과대학제일부속의원치료적폐선암환자48례，채용면역형광법검측환자폐선암간세포표형표지，비교불동표형여환자림상병례특정이급환자예후적관계。결과여결론：48례폐선암조직중균관찰도SP-C표체화CCSP표체，구유폐세지기관폐포간세포적표형특정，기중34례동시표체OCT4(OCT4+지기관폐포간세포조)，14례불표체OCT4(OCT4-지기관폐포간세포조)。OCT4+지기관폐포간세포조화OCT4-지기관폐포간세포조폐선암환자적년령、성별、흡연사이급종류분기차이무현저성의의(P >0.05)；OCT4+지기관폐포간세포조유23례(68%)환자암세포전이，명현고우OCT4-지기관폐포간세포조(21%)，차이유현저성의의(P <0.05)；재선암환자년령、성별、흡연사、분기이급암세포전이등림상병리특정분층중，OCT4-지기관폐포간세포조폐선암2년생존솔보편고우OCT4+지기관폐포간세포조，량조생존곡선차이유현저성의의(P <0.05)。결과표명인폐선암간세포구유폐세지기관폐포간세포표형특정，동시표체배태간세포기인OCT4시，환자예후차，여폐선암전이유관。
BACKGROUND:Lung adenocarcinoma stem cels are a very important marker for diagnosis of lung adenocarcinoma. OBJECTIVE:To investigate the relationship between human lung adenocarcinoma stem cel phenotypes and patient’s prognosis. METHODS:From February 2010 to January 2013, 48 patients with lung adenocarcinoma admitted in the First Affiliated Hospital of Xinjiang Medical University were enroled. Lung adenocarcinoma cancer stem cel phenotypes were detected with immunofluorescence method, and the relationship of different phenotypes and clinical characteristics with patient’s prognosis was compared. RESULTS AND CONCLUSION: SP-C and CCSP expression was observed in the lung adenocarcinoma tissues of 48 cases, possessing the phenotypic characteristics of bronchioloalveolar stem cels. Of the 48 patients, OCT4 was positive in 34 cases (OCT4+ group) and negative in 14 cases (OCT4- group). There was no difference between the two groups in terms of patient’s age, gender, smoking history and tumor stage (P > 0.05). There were 23 cases (68%) in the OCT4+ group with cancer cel metastasis, which was significantly higher than that in OCT4- group (21%;P > 0.05). In the aspects of patient’s age, gender, smoking history, staging and cancer metastasis and other clinical pathological stratification, the 2-year survival rate in the OCT4- group were generaly higher than that in the OCT4+ group, and there was a significant difference in the survival curves of two groups (P < 0.05). Human lung adenocarcinoma stem cels have the phenotypic characteristics of bronchioloalveolar stem cels, and meanwhile, if the cels are positive for OCT4, patient’s prognosis is poor and associated with lung adenocarcinoma metastasis.