TTF-1和NapsinA在非小细胞肺癌中的表达及与临床病理特征及预后关系

Immunohistochemical detection of TTF-1 and NapsinA expression in non-small cell lung cancer and their relationship with clinicopathological features and prognosis

目的探讨甲状腺转录因子-1(TTF-1)、天冬氨酸肽酶A(NapsinA)蛋白表达与非小细胞肺癌(NSCLC)患者临床病理特征及预后的关系。方法收集淮南朝阳医院2014年5月-2017年8月期间诊治的70例NSCLC患者NSCLC组织及癌旁组织,根据5年随访期间患者是否死亡将其分为死亡组(n=38)和生存组(n=32)。采用免疫组化法检测组织TTF-1、NapsinA蛋白表达;采用Kaplan-Meier法绘制不同TTF-1、NapsinA蛋白表达NSCLC患者的生存曲线;采用多因素Cox回归分析NSCLC患者5年预后的影响因素。结果NSCLC组织中TTF-1阳性率(65.71%)、NapsinA阳性率(71.43%)显著高于癌旁组织(11.43%、14.29%),差异均有统计学意义(χ^(2)=43.531、46.667,P均<0.05)。TTF-1、NapsinA蛋白表达与临床分期、病理类型、淋巴结转移、分化程度有关,差异均有统计学意义(χ^(2)=21.043、18.641、13.635、21.652,19.330、7.292、9.307、8.217,P均<0.05);而与年龄、性别、吸烟、肿瘤直径无关,差异均无统计学意义(P均>0.05)。TTF-1、NapsinA蛋白阳性表达患者5年生存率(30.43%、32.00%)显著低于TTF-1、NapsinA蛋白阴性表达患者(75.00%、80.00%),差异均有统计学意义(χ^(2)=12.622、13.263,P均<0.05)。死亡组临床分期III+IV期、有淋巴结转移患者比例高于生存组,差异均有统计学意义(χ^(2)=4.153、16.234,P均<0.05)。TTF-1、NapsinA是NSCLC患者5年内死亡的独立危险因素(HR=2.842、2.646,P均<0.05)。结论NSCLC组织中TTF-1、NapsinA均高表达,二者均与临床分期、病理类型、淋巴结转移、分化程度及预后有关。

Objective To investigate the relationship between thyroid transcription factor-1(TTF-1)and NapsinA protein expression and clinicopathological characteristics and prognosis of patients with non-small cell lung cancer(NSCLC).Methods The NSCLC tissues and adjacent tissues of 70 NSCLC patients diagnosed and treated in the Huainan Chaoyang Hospital from May 2014 to August 2017 were collected;according to whether the patients died or not during the 5-year follow-up,they were grouped into death group of(n=38)and survival group(n=32).The expression of TTF-1 and NapsinA proteins was detected by immunohistochemistry;the survival curves of NSCLC patients with different TTF-1 and NapsinA protein expressions were drawn by Kaplan-Meier method;multivariate Cox regression analysis was applied to analyze the influencing factors of 5-year prognosis of NSCLC patients.Results The positive rates of TTF-1(65.71%)and NapsinA(71.43%)in NSCLC tissues were obviously higher than those in adjacent tissues(11.43%,14.29%),the differences were statistially significant(χ^(2)=43.531,46.667;P all<0.05).The expression of TTF-1 and NapsinA proteins was related to clinical stage,pathological type,lymph node metastasis and degree of differentiation,the differences were statistially significant(χ^(2)=21.043,18.641,13.635,21.652;19.330,7.292,9.307,8.217;P all<0.05),but not related to age,gender,smoking and tumor diameter(P all>0.05).The 5-year survival rate of patients with positive expression of TTF-1 and NapsinA proteins(30.43%,32.00%)was obviously lower than that of patients with negative expression of TTF-1 and NapsinA proteins(75.00%,80.00%),the differences were statistially significant(χ^(2)=12.622,13.263;P all<0.05).The proportions of patients with clinical stageⅢ+Ⅳand lymph node metastasis in the death group were higher than those in the survival group,the differences were statistially significant(χ^(2)=4.153,16.234;P all<0.05).TTF-1 and NapsinA were independent risk factors for 5-year death in NSCLC patients(HR=2.842,2.646;P all<0.05).Conclusion TTF-1 and NapsinA were highly expressed in NSCLC tissues,and both related to clinical stage,pathological type,lymph node metastasis,degree of differentiation and prognosis.