哺乳动物雷帕霉素靶蛋白表达与早期非小细胞肺癌预后的关系

Relationship between expression of mTOR and prognosis of early stage non-small cell lung cancer

目的探讨哺乳动物雷帕霉素靶蛋白（mTOR）表达与早期非小细胞肺癌（NSCLC）预后的关系。方法2002年1月至2006年12月行根治性手术切除的138例NSCLC患者，其中男性83例，女性55例，平均年龄65．8岁。分析患者年龄、性别、肿瘤分型、病理分级、病理分期和mTOR表达情况与预后的关系。结果138例NSCLC患者的5年生存率为44．8％。免疫组化染色结果显示，mTOR阳性101例，mTOR阴性37例。mTOR阳性和mTOR阴性患者的5年生存率分别为32．7％和56．4％，差异有统计学意义（P=0．019）。单因素分析显示，病理分期、mTOR表达情况和N1淋巴结侵犯情况与预后有关（均P〈0．05）。多因素分析显示，病理分期、mTOR表达情况和N1淋巴结侵犯情况是早期NSCLC患者的独立预后因素（均P〈0．05）。结论mTOR过表达提示NSCLC预后不良，是早期NSCLC的独立预后因素。

Objective To investigate the influence of mTOR expression on prognosis of early stage NSCLC. Methods One-hundred and thirty-eight patients who underwent radical surgery for early stage NSCLC in our hospital from Janurary 2002 to December 2006 were included in this study. There were 83 males and 55 females, in an average age of 65.8 years, for both genders）. The influence of age, gender, tumor typing, pathological grading, pathological staging and roTOR expression on patients＇ survival were analyzed by univariate and multivariate analyses. Results The 5-year survival rate of the 138 cases was 44.8%. Immunohistochemical examination showed that mTOR-positive cases accounted for 101 while mTOR-negative cases accounted for 37. The 5-year survival rate of roTOR-positive patients was 32.7% and that of mTOR-negative patients was 56.4% （ P = 0. 019 ）. Univariate analysis showed that mTOR expression, pathological staging and N1 lymph node metastasis were identified as significant prognostic factors, and were correlated to prognosis （P 〈 0.05 for all）. Multivaraite analysis showed that pathological staging, mTOR expression, N1 lymph node involvement were identified as independent prognostic factors for patients with early NSCLC （ P 〈 0.05 for all）. Conclusions Our findings suggest that overexpression of roTOR indicates a poor prognosis for NSCLC. mTOR, pathological stage and N1 lymph node metastasis are independent prognostic factors in early stage NSCLC.