肺癌组织中Toll样受体9的表达及其对术后放疗生存的影响

Effect of Toll-like receptor 9 expression in postoperative radiotherapy in lung cancer survivors

目的:分析肺癌组织中Toll样受体9(TLR9)表达与肺癌临床病理特征的关系及其对肺癌术后放疗结果的影响。方法:收集2007年3月至2011年12月经本院手术治疗的肺癌病史资料63例,采用免疫组化SP法检测癌组织中TLR9的表达,分析TLR9表达与肺癌临床病理特征的关系;通过对36例肺癌术后放疗患者进行Kaplan-Meier单因素生存分析和多因素Cox回归分析,探讨TLR9表达在肺癌术后放疗生存中的意义。结果:正常肺泡细胞内未见TLR9蛋白阳性表达,而TLR9蛋白定位于肺癌组织的肿瘤细胞质中,阳性表达率为68.3%(43/63)。且随着肿瘤直径增加,TLR9表达阳性率增加(P<0.05),淋巴结转移组的TLR9表达阳性率高于无淋巴结转移组(P<0.05)。对36例肺癌术后放疗的生存结果进行分析,其中TLR9表达和肿瘤直径对肺癌术后放疗无进展生存期(PFS)和总生存期(OS)的影响均有统计学意义(P<0.05),淋巴结转移状态和病理类型(鳞癌或腺癌)分别影响着肺癌术后放疗的OS和PFS,差异均有统计学意义(P<0.05);对生存影响因素进行Cox多因素回归分析,结果显示TLR9阳性表达、淋巴结转移是肺癌术后放疗生存的独立预后因素。结论:肺癌组织中TLR9表达阳性率升高,TLR9表达和淋巴结转移是肺癌术后放疗患者生存的独立危险因素,TLR9可能成为预测肺癌术后放疗生存的分子生物学指标。

OBJECTIVE： To analyze the relationship between Toll-like receptor 9（TLR9） expression and clinical pathological staging in lung cancer and its impact on the results of postoperative radiotherapy in lung cancer. METHODS： The medical records of 63 patients who had received surgical treatment in our hospital in March 2007 to December 2011 were analyzed, TLR9 expression of cancer tissue was determined by SP immunohistochemistry methods. The relationship of TLR9 expression and clinical pathological staging in lung cancer was evaluated. We performed Kaplan- Meier survival analysis and multivariate Cox regression analysis on survival factors of 36 patients who received postoperative radiotherapy, and explored the significance of TLR9 expression in postoperative radiotherapy survivors. RESULTS： No TLR9 expression was found in normal pulmonary tissue, while TLR9 protein was localized in the cytoplasm of lung cancer cells. The positive rate of TLR9 protein was 68.3%（43/63）. The TLR9 expression increased with the greater tumor size and lymph node metastasis of lung cancer （P〈0.05）. By analyzing the survival of 36 postoperative radiotherapy lung cancer patients, we found that TLR9 expression and tumor size of lung cancer significantly affected progression-free survival （PFS） and overall survival（OS） of these patients （P〈0.05）. Lymph node metastasis and histological type （squamous cell carcinoma or adenocarcinoma） of also affected OS and PFS of the patients （P〈0.05）. With Cox multivariate regression analysis, TLR9 expression, lymph node metastasis were independent prognostic factors for patient survival. CONCLUSION： Positive TLR9 expression increased in lung cancer. TLR9 expression and lymph node metastasis were independent risk factors on predicting patient survival. TLR9 could become a new molecular biological indicator to predict the survival of lung cancer patients after postoperative radiotherapy.