瘦素和瘦素功能性受体在非小细胞肺癌组织中的表达及其临床意义

目的　研究瘦素（ＯＢ）和瘦素功能性受体（ＯＢ-Ｒｂ）在非小细胞肺癌（ＮＳＣＬＣ）组织中的表达情况，探讨其表达水平与ＮＳＣＬＣ发生、发展及预后的关系。方法　采用免疫组化染色法检测１００例ＮＳＣＬＣ组织以及正常肺组织中ＯＢ和ＯＢ-Ｒｂ的表达，并研究其表达水平与临床病理参数之间的关系，运用单因素和多因素分析其与预后的关系。结果　ＯＢ在ＮＳＣＬＣ组织和正常肺组织的阳性表达率分别为７１％和２６％ （Ｐ＜０.０5），ＯＢ-Ｒｂ则分别为６２％和３１％ （Ｐ＜０.０５），ＨＥＲ-２在ＮＳＣＬＣ组织和正常肺组织的过度表达率分别为５４％和０（Ｐ＜０.０５），三者在ＮＳＣＬＣ中的表达无明显相关性（Ｐ＞０.０５）。ＯＢ、ＯＢ-Ｒｂ和ＨＥＲ-２的表达与本组ＮＳＣＬＣ患者性别、年龄、吸烟史、病理类型均无关（Ｐ＞０.０５）；ＨＥＲ-２的表达与ＴＮＭ分期有相关性（Ｐ＜０.０５）；ＯＢ及ＨＥＲ-２的表达与淋巴转移有相关性（Ｐ＜０.０５）。单因素分析显示，ＮＳＣＬＣ患者性别、年龄、吸烟史和组织病理类型对预后无影响（Ｐ＞０.０５），而ＴＮＭ分期、淋巴结转移、ＯＢ、ＯＢ-Ｒｂ和ＨＥＲ-２表达均对患者预后有显著影响（Ｐ＜０.０５），ＯＢ、ＯＢ-Ｒｂ表达阳性以及ＨＥＲ-２过度表达的患者生存期明显缩短。Ｃｏｘ多因素分析显示，ＯＢ表达和淋巴结转移是影响ＮＳＣＬＣ患者预后的独立因子（Ｐ＝０.０００）。结论　ＯＢ、ＯＢ-Ｒｂ和ＨＥＲ-２在ＮＳＣＬＣ组织中高表达，ＯＢ、ＯＢ-Ｒｂ和ＨＥＲ-２表达高低可以作为区分组织良恶性的指标。ＯＢ、ＯＢ-Ｒｂ表达阳性以及ＨＥＲ-２过度表达的患者生存期明显缩短，ＯＢ表达情况可以作为判断ＮＳＣＬＣ患者预后的参考指标。

Expression and clinical significance of leptin/leptin functional receptor in non-small cell lung cancer

Objective To investigate the expression of leptin（OB） and its functional receptor（OB-Rb） in human non-small cell lung cancer （NSCLC） and investigate their correlations to the occurrence, development and prognosis of NSCLC. Methods The expression level of OB, OB-Rb and HER-2 were detected in 100 NSCLC specimens and their adjacent normal lung tissues by using immunohistochemistry method, using correlation analysis to compare the relationship between these three resuhs with clinieopathologieal features, using single factor survival analysis and multivariate factor analysis to compare the relationship between OB, OB-Rb and HER-2 with the prognosis. Results OB in lung cancer and adjacent normal lung tissues of the positive expression rate was 71% and 26% （ P 〈 0. 05 ） ; OB-Rb were 62% and 31% （P 〈 0. 05 ） ; HER-2 in lung cancer and adjacent normal lung tissues of the over positive expression rate was 54% and 0（P 〈 0. 05）. The expression between the three factors was no significant correlation in NSCLC （P 〉 0. 05 ）. The expression of OB, OB-Rb and HER-2 was no significant relationship with sex, age, smoking history, pathological types （ P 〉 0. 05 ）. The expression level of HER-2 showed correlated with TNM staging （ P 〈 0. 05 ）. The expression level of OB and HER-2 showed correlated with lymph node metastasis （ P 〈 0. 05 ）. Single-facor analysis showed that sex, age, smoking history and histopathological type had no effect on the prognosis （ P 〉 0. 05 ）, and TNM stage, lymph node metastasis, the expression of OB, OB-Rb and HER-2 had significant effect on the prognosis （P 〈 0. 05）. The positive expression of OB, OB-Rh and overexpression of HER-2 group survival time was shorter than the negative expression of OB, OB-Rb and low-expression of HER-2 group. Cox multivariate analysis showed that the expression level of OB arid lymph node metastasis was an independent prognostic factor in patients of NSCLC （ P = 0. 000）. Conclusion OB, OB-Rb and HER-2 is highly expressed in lung tissue, the expression level of OB, OB-Rb and HER-2 can he used as indicators to distinguish benign tissue and malignant tissue. The positive expression of OB, OB-Rb and over positive expression of HER-2 group survival time was shorter than the others. The expression level of leptin may as a judgement to evaluate prognosis of patients with NSCLC.