肺腺癌中CRP蛋白的表达及其预后意义

Expression of CRP protein in lung adenocarcinoma and its prognostic significance

目的通过检测肺腺癌患者肿瘤组织中CRP蛋白的表达量,探讨CRP与肺腺癌患者术后复发及预后的相关性。方法纳入78例接受肺癌根治手术治疗的肺腺癌患者(Ⅰb-Ⅲa期),所有患者术前均未行新辅助化疗及放疗。采用免疫组化法检测切除肿瘤组织中CRP的表达,据检测结果分为CRP表达阳性组及CRP表达阴性组。影像学评估患者术后复发情况。分析肿瘤组织CRP表达阳性与阴性患者的术后生存率及复发率。结果 58%(55/78)的患者肿瘤组织中CRP表达阳性。CRP表达阳性与阴性组在患病年龄、性别、血清CRP水平、瘤体大小、淋巴结转移等临床病理因素上无统计学差异;两组间患者外周血清CRP水平亦无统计学差异。肺腺癌CRP阳性组患者5年生存率较CRP阴性组明显下降(CRP+vs CRP-;41%vs65%),生存率的下降具有统计学差异(P<0.05)。肺腺癌CRP阳性组患者术后复发率较CRP阴性组显著升高(CRP+vs CRP-;54.5%vs 26.1%),两组复发率具有统计学差异(P<0.05)。肺腺癌肿瘤中CRP的表达是患者术后复发的独立因素(OR>1)。CRP阳性复发组与CRP阴性复发组在术后患者初次复发部位上无差异。结论肺腺癌组织中CRP的表达与术后较高的复发率及较差的生存率相关。CRP可能成为评估肺腺癌患者术后预后的重要标志物。

Objective To detect the expression of CRP protein in tumor tissues of lung adenocarcinoma patients and to investigate the correlation between CRP and postoperative recurrence and prognosis in patients with lung adenocarcinoma. Methods A total of 78 lung adenocarcinoma patients （stage I b-ma） with lung cancer undergo- ing radical lung cancer surgery were enrolled. Neoadjuvant chemotherapy and radiotherapy were not performed before operation in all patients. CRP expression was detected by immunohistochemistry, and they were divided into the CRP positive group and the CRP negative group according to the results. It used imageology to evaluate postoperative recurrence. The survival rate and recurrence of CRP positive and negative patients with tumor tissue were analyzed. Results 58% （55/78） of the patients had positive expression of CRP in the tumor tissues. There was no significant difference in the clinical pathological factors such as age, sex, serum CRP level, tumor size, and lymph node metastasis between the positive and negative groups in CRP expression. There was no significant difference in serum CRP level between the two groups. The 5-year survival rate of lung adenocarcinoma was significantly lower in the positive group than in the negative group （CRP-vs CRP ＋ ; 41% vs 65% ）. The decline in survival rate was statistically significant （P 〈 0. 05 ）. The recurrence of lung adenocarcinoma was significantly higher in the positive group than in negative group （CRP- vs CRP ＋ ; 54. 5% vs 26. 1% ）. The recurrence of the two groups was statistically significant （P 〈 0. 05）. The expression of CRP in lung adenocarcinoma tumors was an independent factor （ OR 〉 1 ） in patients with postoperative recurrence. There was no difference in the initial recurrence site between the CRP positive recurrence group and the CRP negative recurrence group. Conclusion The expression of CRP in lung adenocarcinoma tissues is related to the high recurrence and poor survival rate after operation. CRP may be an important marker for evaluating the prognosis of patients with lung adenocarcinoma after surgery.