肺癌中端粒酶逆转录酶基因与雌、孕激素受体的表达及意义

Expression and Clinical Significance of Telomerase and Estrogen and Progesterone Receptors in Primary Lung Cancer

目的:检测端粒酶逆转录酶基因(hTERT)、雌激素受体(ER)、孕激素受体(PR)在肺癌和肺良性病变中的 表达,探讨hTERT、ER、PR在肺癌发生、发展中的作用,在肺癌中他们的相关性以及与肺癌的组织分化程度、病理分型、 TNM分期、淋巴结转移的关系。方法:采用免疫组织化学方法(sp法)检测61例肺癌组织和15例肺良性病变组织中 hTERT、ER、PR的表达,并结合临床病理资料进行统计学分析。结果:肺癌组织中hTERT、ER、PR阳性表达率分别为 65．6％(40/61)、59．0％(36/61)、65．6％(40/61),肺部良性病变组织中hTERT、ER、PR阳性表达率分别为20．0％(3/ 15)、6．6％(1/15)、13．3％(2/15)。肺癌组织hTERT、ER、PR表达显著高于肺部良性病变组织;肺癌组织不同的病理类 型之间、TNM分期之间以及不同分化程度之间hTERT、ER、PR的阳性率未发现明显差异,但hTERT在肺癌淋巴结转移 组表达显著高于非淋巴结转移组;hTERT、ER、PR在肺癌组织中的表达之间无明显相关性;ER与PR在肺癌组织中的表 达有相关关系。结论:hTERT、ER、PR参与各型、各期和不同分化程度肺癌的发生、发展;hTERT在肺癌组织高表达和在 肺良性病变组织低表达的特性,有望使hTERT成为肺癌诊断的一种标志物;hTERT与ER、PR表达无明显相关性,提示 肺癌是由多基因参与的疾病;ER与PR协同表达可能二者互为因果,相互促进参与肺癌的发生、发展。

Objective： To investigate the expression of telomerase hTERT,estrogen receptors（ER） and Progesterone receptors（PR） in lung cancer and benign lesions as well as the role of telomerase,estrogen and progesterone receptors in pathogenesis and progression of lung cancer, the correlations among them and the relationship to histological grade and cell type TNM Stage, and lymph node metastasis in lung cancer. Merthods： Telomerase hTERT,ER,PR were measured in 61 cases of lung cancer and 15 cases of benign lesion by immunohistochemical staining（ s - p method）. Results were compared with clinical pathological featare. Results： Telomerase hTERT was present in 40 of the 61 cases（65.6% ） of tumor and only 3 of 15（20.0% ） in benign lesion tissues. The ER and PR were present in 36 of 61 cases （59.0%） and 40 of 61 cases of （65.6%） lung cancer, respectively. The positive rate of expression of hTERT.ER. PR in lung neoplasms was markedly higher than that in benign lesion tissues. No signiticant correlation between cell type.differentiation degree.staging,telomerase hTERT ,ER,PR was found . The expression of telomerase hTERT was associated with lymph nodes metastasis. There is no significant correlation between the expressions of telomerase,ER.PR in lung neoplasms;There is significant correlation between the expressions of ER and PR in lung neoplasms. Conclusion： Telomerase action is a universal event in different TNM stage.cell type and differentiation; Telomerase presents with high expression in lung cancer and low expression in benign lesions. It suggests that telomerase may be an useful diagnostic marker of lung cancer; There are no significant correlation between telomerase.ER and PR. Multiple genes may be involved in the pathogenesis of lung cancer.