非小细胞肺癌上皮-间质转化与EGFR突变以及临床病理特征之间的关系

Clinicopathologic Features and Epidermal Growth Factor Receptor Mutations Associated with Epithelial-mesenchymal Transition in Non-small Cell Lung Cancer

目的探讨非小细胞肺癌(NSCLC)上皮-间质转化(EMT)与表皮生长因子受体(EGFR)突变和临床病理特征之间的关系。方法采用免疫组化法检测NSCLC患者癌组织中E-钙黏素和波蛋白的表达情况。采用卡方检验和Logistic回归分析,探讨临床病理特征和EGFR基因型NSCLC中EMT的影响。结果62例NSCLC标本中,上皮表型35.48%(22/62)。EGFR突变NSCLC中,上皮表型显著高于野生型(77.78%vs18.18%;P<0.0001);女性显著高于男性(54.55%vs25%;P=0.02);腺癌高于其他病理类型(39.47%vs29.17%;P=0.4087);不吸烟者稍高于吸烟者(42.42%vs27.59%;P=0.2231);年龄<60岁和年龄≥60岁组差异无统计学意义(43.33%vs28.12%;P=0.211),早期肺癌与晚期肺癌组差异无统计学意义(38.24%vs32.12%;P=0.6178)。结论EGFR突变型、女性、非吸烟者、腺癌倾向于上皮表型,与EGFR酪氨酸激酶抑制剂疗效分布人群的临床特征相一致。

Objective To explore clinicopathologic features and epidermal growth factor receptor mutations associated with epithelial-mesenchymal transition in non-small cell lung cancer. Methods The status of epithelial-mesenchymal transition of 62 patients with surgically resected non-small cell lung cancer specimens were tested by immunohistochemical staining. The rate of tumor epithelial phenotype was calculated with stratification factors of clinicopathologic features and EGFR genotype. Statistical significance was assessed by chi-square tests and logistic regression. Results The overall frequency rate of epithelial phe- notype among 62 NSCLC was 35.48% （22 of 62）. The frequency of epithelial phenotype （E-cadherin- positive） was greater for EGFR mutants versus wild types （77. 78% versus 18. 18% ;P〈0. 0001）;fe- males patients versus males patients （54. 55 % versus 25%;P = 0. 02） ;adenocarcinomas versus other histology （39. 47% versus 29. 17% ; P = 0. 4087）; never smokers versus ever smokers （42. 42% versus 27. 59% ;P = 0. 2231） ;age〈60 year versus age≥60 year （43.33% versus 28. 12% ; P = 0. 211 ） ; earlystage disease versus advanced disease （38. 24% versus 32. 12% ; P = 0. 6178）. Conclusion The clinicopathologic features of patients with lung cancer showing epithelial markers tend to be women, nonsmokers, adenocarcinoma and with EGFR mutation.