Ki67、bcl-2、bax蛋白在非小细胞肺癌中的表达及预后价值

Prognostic Value of the Expression of bcl-2,bax,and Ki67 Proteins in Non-Small-Cell Lung Cancer

目的评价增生细胞标志Ki67蛋白及凋亡调节因子bcl-2蛋白、bax蛋白在非小细胞肺癌中表达的临床意义和预后价值。方法用Ki67b、cl-2、bax抗体对51例非小细胞肺癌标本进行免疫组化染色,按阳性及阴性分组。结果Ki67蛋白阳性率为29.4%,Ki67蛋白表达在T分期中不同,在T2期表达强度最高(P=0.033),Ki67蛋白阳性者生存期较阴性者缩短(P=0.013);bcl-2蛋白阳性率为33.3%,bcl-2蛋白表达与临床病理特征无关,与生存期无关;bax蛋白阳性率为35.3%,bax蛋白表达在鳞、腺癌之间不同(P=0.040),bax蛋白表达与生存期无关。多因素COX回归分析显示,进入回归方程的为肺癌分期及Ki67蛋白。结论Ki67蛋白作为增生细胞的标志与预后相关,Ki67蛋白阳性者预后差。Ki67蛋白有可能成为判断非小细胞肺癌预后的一个有价值的分子标志。

Objective To assess the prognostic value of the expression of Ki67, bcl-2 and bax proteins in non-small-cell lung cancer. Methods Non-small-cell lung cancer specimens from 51 patients were immunohistochemically stained with Ki67, bcl-2 and bax antibodies. The expression of the proteins were divided into negative group and positive group. Results The positive expression rate of Ki67 protein was 29.4%. The expression of Ki67 protein was significantly different in T category, and the highest expression of Ki67 protein was in T2 category（P = 0. 033）. Patients with positive expression of Ki67 protein experienced a shorter survival period than those with negative（P = 0. 013）. The positive expression rate of bcl-2 protein was 33.3 %, and it was not significantly associated with clinical features. The expression of bcl-2 protein was not associated with survival period. The positive expression rate of bax protein was 35.3%, and the expression of bax protein was significantly different between squamous cell carcinoma and adenocarcinoma（P = 0. 040）. The expression of bax protein was not associated with survival period. In the multivariate COX regression analysis, the lung cancer staging was the first that entered the COX regression model, the second was Ki67 protein. Conclusion As a biological marker of cell proliferation, and the expression of Ki67 protein is significantly associated with prognosis. The positive staining of Ki67 protein have been linked to poor prognosis, and it may become a valuable biomarker in non-small-cell lung cancer.