细胞外基质在非小细胞肺癌中的表达及与新辅助化疗的关系

Extracellular matrix expression in non small cell lung cancer and its relationship with neo-adjuvant chemotherapy

目的:探讨细胞外基质在非小细胞肺癌中的表达及与新辅助化疗的关系和临床意义。方法:免疫组化Envision法检测73例非小细胞肺癌(分新辅助化疗组与对照组)细胞外基质的表达,并结合临床和病理资料进行相关统计分析。结果:单因素分析发现,2组纤连蛋白阴性表达的患者中位生存期为67个月,而纤连蛋白阳性表达者为38个月,两者之间有统计学差异(P=0.048)。新辅助化疗组中层连蛋白阴性表达与临床缓解率高有关(P=0.022)。Cox比例风险模型对新辅助化疗组的多因素分析发现,病期是影响预后的指标(P=0.003),纤连蛋白和层连蛋白的阴性表达有可能影响患者的预后,但差异未达到统计学意义。结论:某些细胞外基质的高表达可能导致临床缓解率降低,纤连蛋白表达阴性者生存期可能较阳性表达者长。

Objective：To investigate the expression of extracellular matrix in non small cell lung carcinoma （NSCLC） and its relationship with neo-adjuvant chemotherapy and clinical significance. Methods： Seventy three patients with NSCLC were randomly divided into neo-adjuvant chemotherapy group and control group. Expression of extracellular matrix was detected in NSCLC tissues by immunohistochemical Envision method. The association between the expression of extracellular matrix and the clinical and pathological parameters were statistically analyzed. Results： Univariate analysis found that the median survival period was 67 months in 14 patients with low expression of fibronectin and 38 months in 57 patients with positive expression of fibronectin. A significant difference existed between the two groups （ P = 0. 048 ）. The negative expression of laminin in neo-adjuvant chemotherapy group was related with the increase in clinical response. Multivariate analysis by Cox Proportional Hazards Model found that the TNM stage was the only independent prognostic factor. Negative expression of fibronectin and laminin tended to affect the prognosis of patients, but the difference was not significant. Conclusion： Overexpression of some extracellular matrix may induce decrease in clinical response. The fibronectin and laminin-negative patients may have longer survival time than fibronectin and laminin-positive patients.