非小细胞肺癌Lunx mRNA表达临床意义的研究

Expression of Lunx mRNA in non-small cell lung cancer tissues

目的:荧光定量PCR检测肺癌Lunx基因表达对淋巴结微转移的作用和在各类型肺癌中表达及其与临床分期的关系。方法:42例非小细胞肺癌患者开胸手术纵隔淋巴结提取清除以获取原发灶及纵隔淋巴结病理标本,12例非肿瘤肺叶切除作正常对照。荧光定量PCR检测切除肿块和淋巴结的Lunx mRNA表达。结果:1)肺癌组织和肺良性病变组织中Lunx mRNA表达量分别为1840(328,7210)和237.93(148.45,322.70),P=0.002。2)Ⅲ期肺癌组织中Lunx mRNA表达水平〔2245(280,7210)〕与Ⅰ期的〔1840(1840,7210)〕和Ⅱ期〔328(231,2129)〕差异无统计学意义,χ2=1.4,P=0.497。3)Lunx mRNA在鳞癌和腺癌中的表达水平分别为7210(199,7210)和1202.5(328,2650),P=0.484,该指标与组织类型无关。4)Lunx mRNA为269.5定作界值时,诊断阳性淋巴结的灵敏性为96%,特异度99%。85组淋巴结阳性,57组阴性,42例患者142组区域淋巴结Lunx mRNA阳性59.86%(85/142),HE染色42例患者的50组转移淋巴结阳性35.21%(50/142),明显低于FQ-PCR85枚,P<0.05。表明Lunx mRNA FQ PCR法比常规病理具有更高的敏感性,P<0.05,Kappa值为0.519。5)Spearman等级相关分析显示,LunxmRNA与PET-CT的SUV值关系不大,rs=0.268,P=0.03。结论:FQ-PCR扩增Lunx mR-NA是敏感特异地检测肺癌细胞浸润区域淋巴结的方法。

OBJECTIVE： To detect the level of Lunx on the occult mediastinal lymph node involvement,the expression in lung cancer and the clinical pathology type by FQ-PCR.METHODS： Forty-two patients with respectable NSCLC underwent thoracoto-my for clearance of the lymph nodes and the tumor.Twelve case of benign lung lobes worked as the controls.The expressions of Lunx and Lunx mRNA of the excisional tumor were abtained by FQ-PCR.RESULTS： 1）The expression of Lunx mRNA in NSCLC tissues was 1 840（328,7 210） and that in benign tissues was 237.93（148.45,322.70）,P=0.002.2）Lunx mRNA in phase Ⅲ lung cancer was 2 245（280,7 210） and higher than that in phaseⅠ1 840（1 840,7 210）and Ⅱ 328（231,2 129）（χ^2=1.4,P=0.497）.3）The lunx mRNA expression was 7 210（199,7 210） and 1202.5（328,2 650） in squama and adencarcinoma respectively（P=0.484）.4）If the Lunx mRNA boundary value was 269.5,the positive lympho node diagnosis sensitivity was 96% and the specificity was 99%.Eighty-five cases were considered as meterstasis by FQ-PCR while 57 groups were negative.The positive detection rate of Lunx mRNA of 142 regional lymphatic nodes from 42 lung cancer patients were 85（59.86%） positive by FQ-PCR while 50 were positive 35.21%（50/142） by histological immunochemistry（P〈0.05）.FQ-PCR was more sensitive than histochemistry（McNemar：P〈0.05,Kappa=0.519）.5）There was no tight relation between Lunx mRNA and PET-CT SUV（rs=0.268,P=0.03）.CONCLUSION： FQ-PCR amplification of Lunx mRNA is an sensitive and specific means to detect early regional lymphatic nodes dissemination of cancer cells for patients with lung cancer.