小细胞肺癌组织中神经细胞黏附分子、嗜铬蛋白A及突触素的表达及临床相关分析

Expression and clinical analysis of neural cell adhesion molecule,chromogranin A and synaptophysin in small cell lung cancer

目的检测神经细胞黏附分子(NCAM/CD56)、嗜铬蛋白A(CgA)及突触素(Syn)在小细胞肺癌(SCLC)组织中的表达,探索其在SCLC组织中表达的意义与价值。方法应用组织反转录聚合酶链反应(RT-PCR)及免疫组织化学方法检测CD56、CgA及Syn在15例SCLC、15例非小细胞肺癌(NSCLC)和10例正常组织中的表达,并应用Fisher确切概率法检验分析表达结果。结果 CD56、CgA、Syn基因在SCLC组织中表达的阳性率高于NSCLC及正常组织,差异均有统计学意义(P<0.05);3项指标联合检测SCLC的敏感性为93.3%,特异性为96.0%,准确性为90.0%;CgA基因在SCLC广泛期的表达(77.8%)高于局限期的表达(0.0%),在有淋巴结转移组织的表达(70.0%)高于无淋巴结转移组织的表达(0.0%)。CD56和Syn蛋白在SCLC组织中的表达高于NSCLC组织和正常组织(P<0.05);但是CgA蛋白在SCLC、NSCLC及正常组织中表达的阳性率比较,差异均无统计学意义(P>0.05)。结论 CD56、CgA、Syn的检测对SCLC的诊断具有重要意义,CgA基因的表达水平可以间接反映SCLC分期。

Objective To detect the expression of neural cell adhesion molecule（NCAM/CD56） ,chromogranin（CgA） and synaptophysin （Syn）in small cell lung carcinoma （SCLC）and investigate the value for diagnosis and clinical stages in SCLC. Methods Reverse-transcription polymerase chain reaction （RT-PCR） and immvnohistochemistry method were per- formed to detect CD56 ,CgA,Syn in 15 tumor tissues from SCLC patients,as well as 15 tissues from non-small cell lung carci- noma（NSCLC） and 10 normal tissues. The results were analyzed by Fisher＇s exact probabilities. Results In SCLC, the posi- tive rates of CD56, CgA, Syn mRNA genes were obviously higher than those in NSCLC and normal tissue, there were significant differences（ P 〈 0.05 ）. With combined detection of CD56, CgA, Syn, the results indicated that sensitivity for diagnosis was 93.3% ,specificity was 96.0% and accuracy was 90.0% in SCLC. Expression of CgA gene in extensive period（77.8% ） of SCLC was higher than that in bruited period（0.0% ）, and the expression in SCLC with lymphatic metastasis （70%） was higher the that in SCLC with non-lymphatic metastasis（0.0% ）. The protein expressions of CD56 and Syn were higher than those in NSCLC and normal tissue（ P 〈 0.05 ）. The protein expression of CgA was higher than that in NSCLC and normal tissue, but there was no significant difference（P 〉 0.05 ）. Conclusion The detection of CD56, CgA, Syn is much more helpful to diag- nose SCLC. Moreover, CgA gene expression can reflect different stages of SCLC indirectly.