人类异常纺锤体样小头畸形相关蛋白在非小细胞肺癌中的表达及其临床意义

目的探讨非小细胞肺癌（NSCLC）患者肿瘤组织和癌旁组织中人类异常纺锤体样小头畸形相关蛋白（ASPM）的表达情况及其与患者临床病理参数和预后的关系。 方法收集175例随访满5年的NSCLC患者术后石蜡标本，包括肿瘤组织和癌旁组织，采用免疫组织化学染色法检测各组织中ASPM的表达情况。比较ASPM不同表达水平患者的年龄、性别比、分化程度构成比、吸烟史、病理类型、肿瘤大小、淋巴结转移及TNM分期构成比；绘制Kaplan-Meier生存曲线，采用log-rank检验比较NSCLC患者的5年总生存率；采用Cox回归模型分析影响NSCLC患者预后的危险因素。 结果免疫组织化学染色结果显示，64.57%（113 / 175）的肿瘤组织标本中呈ASPM高表达，而癌旁组织中仅有22.29%（39 / 175）呈ASPM高表达，NSCLC患者肿瘤组织中的ASPM高表达占比显著高于癌旁组织（ χ² = 63.683，P < 0.001）。根据肿瘤组织标本染色结果，将175例NSCLC患者标本分为ASPM低表达组（62例）和ASPM高表达组（113例）。两组患者肿瘤大小（ χ² = 5.060，P = 0.024）、淋巴结转移（ χ² = 3.998，P = 0.046）及TNM分期构成比（ χ² = 5.427，P = 0.020）比较，差异均有统计学意义。Kaplan-Meier生存曲线结果显示，ASPM低表达组NSCLC患者5年总生存率显著优于ASPM高表达组（ χ² = 5.040，P = 0.025）。将肿瘤大小、淋巴结转移、TNM分期及ASPM表达纳入Cox回归分析，结果显示TNM分期[风险比（HR）= 3.883，95%置信区间（CI）（1.616，9.330），P = 0.005]和ASPM表达[HR = 3.845，95%CI（1.795，8.236），P = 0.008]是影响NSCLC预后的危险因素。 结论ASPM在NSCLC患者肿瘤组织中呈高表达，且其表达水平是影响NSCLC患者预后的危险因素。

Expression of abnormal spindle-like microcephaly associated protein in non-small cell lung cancer and its clinical significance

ObjectiveTo investigate the expression of abnormal spindle-like microcephaly associated protein (ASPM) in tumor and paracancerous tissues of patients with non-small cell lung cancer (NSCLC) and its relationship with their clinicopathological parameters and prognosis. MethodsParaffin samples including tumor and paracancerous tissues were collected from 175 NSCLC patients who had been followed up for 5 years and the expression of ASPM was detected by immunohistochemical staining in each tissue. The age, sex ratio, differentiation ratio, smoking history, pathological type, tumor size, lymph node metastasis and TNM staging ratio were compared among patients with different ASPM expression levels. The Kaplan-Meier survival curve was drawn and the 5-year overall survival rate of NSCLC patients was compared by the log-rank test. The Cox regression model was used to analyze the risk factors for the prognosis of NSCLC patients. ResultsThe immunohistochemical staining revealed that 64.57% (113 / 175) of tumor tissue samples showed high expression of ASPM, while only 22.29% (39 / 175) of adjacent tissues showed high expression of ASPM. The high expression ratio of ASPM in tumor tissues of NSCLC patients was significantly higher than that in adjacent tissues ( χ² = 63.683, P < 0.001). The 175 NSCLC patients were divided into an ASPM low expression group (n = 62) and an ASPM high expression group (n = 113) according to the staining results of tumor tissue samples. The tumor size ( χ² = 5.060, P = 0.024), lymph node metastasis ( χ² = 3.998, P = 0.046) and TNM staging ( χ² = 5.427, P = 0.020) were statistically significantly different between these two groups. The Kaplan-Meier survival curve showed that the 5-year overall survival rate of NSCLC patients in the ASPM low expression group was significantly better than that in the ASPM high expression group ( χ² = 5.040, P = 0.025). The tumor size, lymph node metastasis, TNM stage and ASPM expression were included in the Cox regression analysis, and the result showed the TNM stage [hazard ratio (HR) = 3.883, 95% confidence interval (CI) (1.616, 9.330), P = 0.005] and ASPM expression [HR = 3.845, 95%CI (1.795, 8.236), P = 0.008] were risk factors for the prognosis of NSCLC patients. ConclusionASPM is highly expressed in the tumor tissues of NSCLC patients, and its expression is a risk factor for their prognosis.