多基因表达对非小细胞肺癌术后预后的评价

The Prognostic Value of Expression of Multiple Genes on Resected Non-Small Cell Lung Cancer Tissues

目的前瞻性探讨癌基因p53、环氧合酶-2(COX-2)、表皮生长因子受体(EGFR)、血管内皮生长因子(VEGF)、细胞增殖核抗原(PCNA)、MYC、p21和nm23等蛋白在非小细胞肺癌(non-sm all cell lung cancer,NSCLC)组织表达及其对预后的影响。方法采用免疫组织化学染色法检测40例NSCLC瘤组织中上述蛋白表达,并分析这些参数与患者预后之间的关系。结果p53、COX-2、EGFR、VEGF、PCNA、MYC、p21和nm23蛋白表达率分别为77.5%(31/40)、67.5%(27/40)、57.5%(23/40)、87.5%(35/40)、90%(36/40)、87.5(35/40)、32.5%(13/40)和32.5%(13/40)。多因素Cox回归分析示,EGFR是影响该组患者生存期的独立因素。EGFR阳性表达的NSCLC患者生存期明显短于EGFR阴性表达者(P=0.018)。结论在NSCLC,存在上述8种基因蛋白的表达;EGFR表达与NSCLC患者术后预后不良相关。

Objective To explore the prognostic effects of the expressions of p53, COX-2, epidermal growth factor receptor（EGFR）, vascular endothelial growth factor（VEGF）, PCNA, MYC, p21 and nm23 in the resected NSCLC tissues on the survival of the patients. Methods Immunohistochemical analysis was used to investigate the expression of the above proteins in 40 patients who were completely resected at our hospital. Results The positive expression rates of p53, COX-2, EGFR, VEGF, PCNA, MYC, p21 and nm23 were 77.5% （31/40）, 67.5% （27/40）, 57.5% （23/40）, 87.5%（35/40）, 90%（36/40）, 87.5（35/40）, 32.5% （13/40） and 32.5% （13/40）, respectively. The multivariate analysis with Cox hazard model and Kaplan-Meier method showed the expression of EGFR was an independent prognostic factor （P〈0.05） for this group of patients. Conclusion In NSCLC patients, the above eight proteins were over-expressed. EGFR was an independent prognostic factor.