半胱氨酰天冬氨酸特异性蛋白酶-8对非小细胞肺癌脑转移的预测价值

Predictive value of cysteinyl aspartate-specific protease-8 in predicting non-small cell lung cancer brain metastasis

目的 探讨半胱氨酰天冬氨酸特异性蛋白酶（Caspase）-8在非小细胞肺癌脑转移中的预测价值.方法 采用免疫组织化学方法研究284例手术治疗的非小细胞肺癌患者Caspase-8的表达,利用Kaplan-Meier法评价脑转移发生时间与Caspase-8表达的关系.结果 284例患者中,女104例,男180例;平均年龄（62.5±10.5）岁;中位随访时间29.5个月（12 ～ 108个月）,随访期间共有8.1％ （23/284）的患者发生了脑转移.在Caspase-8高表达组脑转移发生率为14.0％ （15/107）,而Caspase-8低表达组脑转移发生率仅为4.5％（8/177）.单因素和多因素Cox回归模型提示,Caspase-8是肺癌脑转移的独立危险因素.Caspasc-8高表达能够预测早期的脑转移（Log-rank检验,P＜0.05）.结论 Caspase-8高表达与非小细胞肺癌患者术后脑转移明显相关,Caspase-8可以作为肺癌脑转移高危患者筛选的标志.

Objective To valuate cysteinyl aspartate-specific protease （Caspase）-8 as a useful marker in predicting non-small cell lung cancer （NSCLC） metastasis to brain.Methods Caspase-8 was detected by immunohistochemistry in 284 NSCLC patients who received surgery during Apr.2004 to Apr.2012.Time to brain metastasis was estimated using Kaplan-Meier method.Results There were 104 females and 180 males in the whole 284 patients.The average age was （62.5 ± 10.5） years （29-85 years）.The median follow-up time was 29.5 months （12-108 months）.There was 8.1% （23/284） of the patients who experienced brain metastasis.Brain metastasis was identified in 14.0% （15/107） patients in Caspase-8 high expression group,and only 4.5% （8/177） patients in low level group developed brain metastasis.Univariate logistic regression and multivariable Cox regression analysis demonstrated Caspase-8 was an independent variable affecting lung cancer brain metastasis.Elevated Caspase-8 predicted early spread to brain （Log-rank test,P 〈 0.05）.Conclusion High level of Caspase-8 was associated with increased incidence of brain metastasis after surgery in NSCLC patients.Caspase-8 can be used as a biomarker for identification of patients at high risk of brain metastasis.