【作者】 张月峰； 李保庆；

【Author】 Zhang Yue-Feng Li Bao-Qing Department of thoracic surgery, the Forth hospital of Hebei Medical University, China

【机构】 河北医科大学第四医院暨河北省肿瘤医院；

【摘要】 目的:本研究通过对非小细胞肺癌组织中E-钙粘蛋白表达的检测,分析其在非小细胞肺癌中的表达情况,探讨其与非小细胞肺癌分化,分期,以及转移的关系。方法: 采用免疫组化技术对52例非小细胞肺癌中E-钙粘蛋白的表达进行检测。平均阳性细胞数超过70％的为阳性,低于 70％的为阴性。采用SPSS 10．0进行统计学分析,组间率的比较用卡方检验,生存分析采用Kaplan—Meier法,并以 Log—rank法检验分析组间差异,p≤0．05为有统计学意义。结果:1．E-钙粘蛋白在非小细胞肺癌中的表达主要定位于细胞膜,表达阳性的为28例,阴性24例,阳性率53．8％。 2．E-钙粘蛋白与分型的关系:鳞癌27例,腺癌25例,E- 钙粘蛋白阳性率分别为48．1％,60．0％,P=0．118。3．E- 钙粘蛋白与组织分化的关系:高分化者9例,中分化者30 例,低分化者13例,E-钙粘附蛋白表达阳性率分别为77． 8％,63．3％,15．4％,P=0．004。4．E-钙粘蛋白表达与分期的关系:I期病例28例,Ⅱ期病例13例,Ⅲ期病例11 例,E-钙粘附蛋白表达阳性率分别为71．4％,30．8％,36． 4％,I与Ⅱ,Ⅲ期相比有显著性差异(P=0．022),Ⅱ期与Ⅲ期相比没有统计学意义。5．E-钙粘蛋白表达与预后的关系: E-钙粘蛋白表达阳性的1年,3年和5年生存率分别为82％,39％和25％,E-钙粘蛋白表达阴性的1年,3年和5年生存率分别为79％,37％,21％。采用Kaplan—Meier 法,并以Log—rank法检验分析组间差异,P=0．61。结论: 1．本组病例中E-钙粘蛋白表达阳性率为53．8％,46．2％的病例中E-钙粘蛋白的表达降低或丧失。表达降低或丧失与肺癌的分化程度成正相关。E-钙粘蛋白在鳞癌与腺癌中表达分别为48．1％,60．0％,说明E-钙粘蛋白的表达与非小细胞肺癌的组织病理学类型没有关系。2．随着肺癌临床分期的进展,E-钙粘蛋白表达的阳性率下降,表明E-钙粘蛋白在非小细胞肺癌的发生,发展中起了抑制性的作用。 E-钙粘蛋白在肿瘤细胞膜表面减少,导致肿瘤细胞间的粘附性下降从而使肿瘤细胞具有运动性和浸润性。3．本实验结果提示E-钙粘蛋白与非小细胞肺癌的预后没有明显相关关系, E-钙枯蛋白不能作为一个判断非小细胞肺癌患者预后的独立指标。更多还原

【Abstract】 Objective: In this study, we examine the expression of E-cadherin in non-small cell lung cancer and analyze the relation between E-cadherin and differentiation, stage and metastasis of cancer in order to develop new strategies in cancer therapy. Methods: Imunohistochemical technique was performed to detect the expression of E-cadherin of 52 cases of non-small cell lung cancer.. We definite normal expression or high expression when more than 70% cells were stained and low or negative expression when less than 30% cells were stained. The Kaplan-Meier method was used to calculate the long-term survival according to the extent of staining for E-cadherin; statistical significance was assessed with log-rank test. All statistical analyses were performed with the use of a SPSS 10.0 software package (SPSS Inc. USA). Differences were considered to be statistically significant when the P value was equal to or less than 0.05. Results: Expression of E-cadherin was located on cytomembrane. Of the 52 specimens of non-small cell lung cancers, positive rate of E-cad expression was 53.8% (28/52). Of the 52 cases, 27 cases were squamous cell cancers and 25 cases were adenocarcinomas. The positive rate of E-cadherin was 48. 1 %, 60.0% respectively. There is no difference between two groups (P=0.118). The relation between E-cadherin and differentiation: 9 cases were high differentiation, 30 cases were middle differentiation and 13 cases were low differentiation. The positive rate of E-cadherin was 77.8%, 63.3% and 15.4% respectively. There is difference between there groups (P=0.004). The relation between E-cadhrin and stage: There are 13 cases of stage II and 11 cases of stage III according to classification suggested by UICC in 1997. The positive rate of E-cadherin was 71.4%, 30.8% and 36.4% respectively. There is different between I, II and III stage (P=0.022). The relation between E-cadherin and prognosis: the 1, 3 and 5-year survival rate of E-cadherin positive cases was 82%, 39% and 25% respectively. The 1, 3 and 5-year survival rate of E-cadherin negative was 79%, 37%, 21%. There is no dif- ference between positive and negative group according toKaplan-Meier method (P=0.61). Conclusion: Positive rate of E-cadherin is 53.8% in non-small cell lung cancer. The loss or induced expression is positive correlation to the differentiation of cancer. There is no relation between the expression of E-cadherin and histology cateloge. With the progress of stage, the expression rate of E-cadherin is decreasing (P<0.05). In this study, the expression of E-cadherin has no relation to the prognosis of non-small cell lung cancer.更多还原