ABH及Lewis组织-血型抗原异常表达与原发肺癌生物学行为的相关性研究

Investigation of expression of ABH and Lewis blood group antigens and their relationship to the biological behaviors of primary lung cancer

目的探讨原发性肺癌组织中ABH及Lewis组织-血型抗原表达与肺癌生物学行为的相关性。方法采用免疫组织化学SP法,检测30例正常肺组织、143例原发肺癌及相应41例转移灶中ABH与Lewis血型抗原的表达。结果A、B、AB、O(H)血型瘤体抗原阳性率分别为49.02%、55.56%、35.00%、69.44%,各血型间抗原表达无统计学差异(P>0.05),Lewisa、sialylLewisx在癌组织中的表达率高于正常肺组织(P=0.045,P=0.015)。低分化癌组织ABH缺失、Lewisa、sialylLewisx表达均高于中高分化癌组织(P<0.001)。转移组ABH抗原表达缺失、sialylLewisx抗原表达均高于未转移组(P=0.004,P<0.001),转移灶ABH抗原表达缺失、sialylLewisx抗原表达高于原发癌(P<0.001)。ABH、sialylLewisx表达与未表达组5年生存率分别为32%、6%﹙P<0.001),7%、30%(P=0.0012)。结论原发肺癌组织中存在ABH及Lewis相关抗原的异常表达;ABH血型抗原表达缺失和sialylLewisx表达增加与肺癌转移相关;Lewisa、sialylLewisx抗原异常表达与肺癌组织分化程度有关;ABH及sia-lylLewisx抗原检测对预测患者预后有重要意义。

Objective To investigate expression of ABH and Lewis histo-blood group antigens and their relationship to differentiation,tumorigenesis,progression,metastasis and prognosis of primary lung cancer. Methods Expression of ABH and Lewis histo-blood group antigens （Lewis^a、Lewis^b、sialyLewis^x and Lewis^y ） were detected in normal lung tissues （ n = 30 ）, primary lung cancers （ n = 143 ） and corresponding metastatic lesions （ n = 41 ） using the immunohistochemical SP method. Results The positive expression ratios of A,B,AB and O blood groups were 49. 02% （25 /51）,55. 56% （20 /36）,35. 00% （7 /20） and 69. 44% （25 /36）respectively in lung cancers,and no significant difference was detected between these blood groups （P〉0. 05）. The expression of Lewis^a（P = 0. 045） and sialylLewis^x（P = 0. 015） was significantly higher in lung cancer tissues than that in normal lung tissues. The absent expression of ABH was significantly associated with differentiation （P〈0. 001） and metastasis （P = 0. 004）. The higher expression of sialyLewis^x was significantly associated with differentiation （P〈0. 001） and metastasis （P〈0. 001）. The 5-year survival rate of patients without expression of ABH antigens was significantly lower than those with expression of ABH antigens （6% vs 32% ,P〈0. 001）. The 5-year survival rate of patients with expression of sialylLewis^x was significantly lower than those without expression of sialylLewis^x（7% vs 30% ,P = 0. 0012）. Conclusion Abnormal expressions of ABH and Lewis antigens were detected in primary lung cancers. Their abnormal expressions were significantly associated with differentiation,metastaisis and prognosis. ABH and sialyLewis^x antigens might be useful predictors of an aggressive phenotype and a potential therapeutic target in primary lung cancer.