ABH及Lewis A组织-血型抗原表达与原发肺腺癌转移和预后的关系

Correlation between expression of ABH and lewis histoblood group antigens with metastasis and prognosis of primary adenocarcinoma of lung

目的探讨ABH及LewisA组织-血型抗原表达与原发肺腺癌转移、预后的关系。方法免疫组织化学S-P法检测30例正常肺组织、103例原发肺腺癌及相应41例转移灶中的ABH及LewisA血型抗原表达。结果癌组织中A、B、H抗原表达缺失,低分化组缺失明显高于中高分化组(P<0.001),正常肺组织、原发癌及转移灶表达缺失率逐步增加(P<0.001),原发癌转移组缺失明显高于未转移组(P=0.036),转移灶缺失表达高于其相应原发癌(P=0.008)。Ⅰ、Ⅱ、Ⅲ+Ⅳ期间LewisA表达有显著性异性(P=0.001),中晚期(Ⅱ+Ⅲ+Ⅳ)期LewisA阳性表达率高于早期癌(Ⅰ期,P<0.001)。ABH阳性表达者5年生存率为25%,高于阴性表达组(P<0.0001);LewisA阳性表达者5年生存率7%,低于阴性表达组(P=0.0002)。结论ABH抗原表达缺失与腺癌发生转移有密切关系;ABH及LewisA抗原检测对预测患者预后有重要意义。

To investigate the correlation between the expression of ABH along with Lewis A histo-blood group antigens and the differentiation, tumorigenesis, progression, metastasis and prognosis of primary adenocarcinoma of lung. The expression of ABH and Lewis A histo-blood group antigens were detected in normal tissue (n =30), primary adenocarcinoma (n =103) and corresponding metastatic lesion (n =41) with immunohistochemistry S-P method. The expression of ABH antigens were absent in cancer tissue and the absence in poorly differentiated tumor was significantly higher than in highly differentiated cell (P <0.001). The absent expression was more obvious when compared among normal tissue, primary cancer and the metastatic focus (P <0.001), and also seen when compared between the tumor without and with metastasis (P =0.036), between primary and secondary tumor (P =0.008). There was significant difference among Stage I, II, III+IV concerning the expression of Lewis A(P =0.001), and the positive expression rate in moderate to advanced cancer (StageⅡ+Ⅲ+Ⅳ)was higher than in early cancer (Stage I). The 5-year survival of positive expression of ABH antigen was 25%, higher than that in negative expression group (P <0.0001). The 5-year survival in positive expression of Lewis A antigen was 7%, lower than in negative group (P =0.0002). [Conclusion] The absence of ABH antigen is closely correlated with tumorigenesis and metastasis of primary adenocarcinoma. The detection of ABH, Lewis A antigen may be of vital significance for the prognosis.