凋亡相关基因在Ⅰ、Ⅱ期非小细胞肺癌组织中的表达及临床意义

Expression and Clinical Significance of Apoptosis-related Oncogenes in Stage Ⅰ-Ⅱ Non-small Cell Lung Cancer

背景与目的:手术后Ⅰ、Ⅱ期非小细胞肺癌的预后与众多因素有关,凋亡基因在肿瘤的发生发展过程中发挥重要的作用。通过检测凋亡基因Survivin、Bcl-2、Bax和Fas在早期非小细胞肺癌中的表达,探讨其在早期非小细胞肺癌中的临床意义和预后价值。方法:利用免疫组织化学技术检测115例Ⅰ、Ⅱ期非小细胞肺癌及20例肺非肿瘤组织中Survivin、Bcl-2、Bax和Fas的表达,并进行5年生存率的多因素分析。结果:115例Ⅰ、Ⅱ期非小细胞肺癌组织中Survivin、Bcl-2、Bax、Fas的表达率分别为62.61%(72/115)、49.57%(57/115)、31.30%(36/115)和46.96%(54/115),与其在肺非肿瘤组织中的表达分别为10.00%(2/20)、15.00%(3/20)、65.00%(13/20)、80.00%(16/20),差异有显著性(P<0.05);患者5年生存率的多因素分析:TNM分期与Survivin蛋白的阳性表达是Ⅰ、Ⅱ期非小细胞肺癌患者独立预后因素(P<0.01),Survivin阳性组的术后生存时间[(33±7)个月]与阴性组术后生存时间[(52±9)个月]差异有显著性(P<0.05)。结论:在Ⅰ、Ⅱ期非小细胞肺癌中,凋亡相关基因可能对肿瘤的发展与预后产生一定的影响;TNM分期与Survivin基因的阳性表达是Ⅰ、Ⅱ期非小细胞肺癌术后患者的独立预后因素。

BACKGROUND ＆ OBJECTIVE. The prognosis of stage Ⅰ-Ⅱ non-small cell lung cancer （NSCLC） after operation is related to many factors. Apoptosis-related oncogenes play an important role in occurrence and development of tumors. This study was to investigate the expression and prognostic significance of representative apoptosis-related oncogenes （Survivin, Bcl-2, Bax, and Fas） in stage Ⅰ-Ⅱ NSCLC. METHODS： The expression of Survivin, Bcl-2, Bax, and Fas in 115 specimens of stage Ⅰ-Ⅱ NSCLC and 20 specimens of non-tumor lung tissue were detected by SP immunohistochemistry. RESULTS： The positive rates of Survivin and Bcl-2 were significantly higher in NSCLC than in non-tumor lung tissues （62.61% vs. 10.00%, P〈0.001; 49.57% vs. 15.00%, P〈0.05）; the positive rates of Bax and Fas were significantly lower in NSCLC than in non-tumor lung tissues （31.30% vs. 65.00%, P〈0.05; 46.96% vs. 80.00%, P〈0.05）. TNM stage and positive expression of Survivin were independent prognostic factors of stage Ⅰ-Ⅱ NSCLC （P〈0.01）. The survival time of patients was significantly shorter in Survivin-positive group than in Survivin-negative group [ （33±7） months vs. （52±9） months, P〈0.05]. CONCLUSIONS： Apoptosisrelated oncogenes may have some impacts on the occurrence and development of stage Ⅰ-Ⅱ NSCLC. TNM stage and positive expression of Survivin are independent prognostic factors.