BCL-2蛋白、NM23基因/NDPK、CEA在非小细胞肺癌的表达及其意义

BCL-2 PROTEIN NM23 GENE/NDPK. CEA EXPRESSION AND SIGNIFICANCE IN NON-SMALL-CELL LUNG CANCER

目的 探讨非小细胞肺癌(NSCLC)中bcl-2蛋白、nm23基因/NDPK、CEA的表达及其在NSCLC发生、转移、预后中的意义.方法 采用亲和素-生物素-过氧化物酶复合物(ABC)免疫酶标法检测65例NSCLC、42例癌旁正常肺组织bcl-2蛋白、nm23基因/NDPK、CEA的表达情况.结果NSCLC中bcl-2蛋白、nm23基因/NDPK、CEA阳性率分别为33.8%、70.8%、61.5%,腺癌、腺鳞癌CEA阳性率(90%、60%)明显高于鳞癌(20%,P<O.01).nm23基因/NDPK阳性率在NSCLC伴淋巴结阳性组低于淋巴结阴性组(58.1%,82.4%,P<0.05);且Ⅰ、Ⅱ期患者阳性率高(84.6%、85.7%),Ⅲ期患者低(56.3%,P<0.05).CEA阳性率在NSCLC伴淋巴结阳性组高于淋巴结阴性组(87.1%,38.2%,P<0.001);且Ⅰ期患者阳性率低(34.6%),Ⅱ、Ⅲ期患者高(100%、75%,P<0.001);CEA阳性患者术后生存率明显低于CEA阴性者(P<0.05).结论 (1)bcl-2基因与部分NSCLC的发生有关,而与NSCLC淋巴结转移、PTNM分期、生存率无关.(2)nm23基因/NDPK与淋巴结转移呈负相关;临床分期越晚,阳性率越低;与生存率无关.(3)CEA可作为NSCLC早期诊断、鉴别诊断的参考指标.

PURPOSEThe expression of bcl-2 protein. nm23 gene /NDPK. CEA in NSCLC were examined to prove the significance in the carcinogenesis. metastasis and prognosis of NSCLC. METHODS The expression of bcl-2 protein, nm23 gene/NDPK, CEA were immunohistochemically detected with ABC method in 65 NSCLC and 42 adjacent normal lung tissue. RESULTS The positive rate of bcl-2 protein. nm23 gene/NDPK, CEA in NSCLC was 33. 8%, 70. 8%. 61. 5% respectively. The positive rate of CEA was higher in adenocarcinoma. adenosquamous carcinoma than in squamous cell carcinoma (90%, 60% : 20%, P<0. 01). Normal alveolar epithelium was all negative, hut atypical hyperplasia alveolar epithelium was positive, its positive rate of bcl-2 protein. nm23 gene/NDPK. CEA was 14. 3%. 71. 4%. 85. 7%. The positive rate of nm23 gene/NDPK was lower in positive lymph node status than in negative lymph node status (58. 1%. 82. 4%, P<0. 05). The later the pathologic stage, the lower was the positive rate ( I stage 84. 6%, I stage 85. 7% : I stage 56. 3%. P<0. 05) . The positive rate of CEA was higher in positive lymph node status than in negative lymph node status (87. 1%. 38. 2. P<0. 001). The later the pathologic stage, the higher was the positive rate ( Ⅰ stage 34. 6%: Ⅱ stage 100%, Ⅲ stage 75%. P<0. 001) . The survival rate was lower in CEA positive than negative. CONCLUSION 1. Bcl-2 gene expression was associated with carcinogenesis of a portion of NSCLC. but no significant difference in lymph node status, pathologic stage and survival rate. 2. Low levels of nm23 gene/NDPK expression was associated with positive lymph node status, advanced pathologic stage. No correlation with the survival rate. 3. CEA may be as a useful marker in early diagnosis and differential diagnosis, and its expression may have prognostic importance.