多基因表达对IIIA期非小细胞肺癌术后转移及生存期的影响

目的前瞻性探讨抑癌基因p53,癌基因K-ras、HER2, 血管内皮生长因子(VEGF),表皮生长因子受体(EGFR),粘连因子CD44,金属蛋白酶MMP9等蛋白表达对ⅢA期非小细胞肺癌(NSCLC)术后复发转移和生存期的影响.方法采用免疫组织化学方法检测32例ⅢA期非小细胞肺癌手术标本中上述蛋白表达.结果 p53、K-ras、VEGF、EGFR、CD44、MMP9和HER2蛋白表达率分别为62.5%(20/32)、34.3%(11/32)、25.0%(8/32)、46.9%(15/32)、78.1% (25/32)、50%(16/32)和43.8%(14/32).K-ras,EGFR蛋白表达与疾病进展时间(time to progression,TTP)有关(P=0.030, P=0.008).多变量Cox回归分析,K-ras,HER2蛋白表达是影响生存期的独立影响因素.Kaplan-M 生存分析显示K-ras,HER2 阳性组生存期明显短于阴性组(P=0.042,P=0.039).结论对于ⅢA期NSCLC,上述7种因子阳性表达率很高.K-ras,EGFR蛋白表达阳性患者术后更易发生远处转移, K-ras,HER2表达是影响生存期的独立影响因素.

The impact of the expression of multiple genes on the metastasis and survival in resected stage IIIA non-small cell lung cancer(NSCLC) patients

Objective To explore prospectively the impact of the expression of p53,K-ras,HER2,vascular endothelial growth factor(VEGF), epidermal growth factor receptor(EGFR),CD44,metalloproteins(MMP9) on the metastasis and survival in resected stage IIIA NSCLC patients. Methods Immunohistochemical analysis was used to investigate the expression of the above mentioned protein expression in 32 patients with completely resected stage IIIA NSCLC patients. Results The positive expression rates of p53,K-ras,VEGF,EGFR,CD44,MMP9 and HER2 were 62.5%(20/32), 34.3%(11/32), 25.0%(8/32), 46.9%(15/32), 78.1% (25/32), 50%(16/32) and 43.8%(14/32), respectively. The expression of K-ras and EGFR was significantly related to time to progression(TTP),( P=0.030, P=0.008).The multivariate analysis with Cox hazard model and Kaplan-Meier method showed the expression of K-ras and HER2 were independent prognostic factors (P<0.05). Conclusion In NSCLC patients with stage IIIA ,the expressions of the above seven factors are very high. K-ras and EGFR were related to postoperative metastasis and K-ras and HER2 were independent prognostic factors.