E-钙黏蛋白和波形蛋白在非小细胞肺癌中的表达及意义

Expression levels and significance of E-cadherin and Vimentin in non-small cell lung carcinoma

目的检测非小细胞肺癌（NSCLC）组织中E-钙黏蛋白（E-cadherin）和波形蛋白（Vimentin）的表达，探讨联合检测E-cadherin和Vimentin对其预后的判断价值。方法选择94例NSCLC术后留取的蜡块及临床资料作为观察组，选择80例正常肺组织作为对照组，采用免疫组织化学染色技术检测E-cadherin和Vimentin在两组中表达，对NSCLC患者进行术后随访，进行生存分析，分析两者在NSCLC中表达的相关性和预后价值。结果E-cadherin主要表达于细胞膜，也可以表达在细胞质。在80例正常组中有62例E-cadherin阳性表达，阳性表达率为77.50%，显著高于NSCLC组的41.49%（39/94），差异有统计学意义（χ^2=26.235，P=0.000）。E-cadherin在NSCLC中的阳性表达与无胸膜侵袭（χ^2=7.799，P=0.005）、无淋巴结转移（χ^2=17.094，P=0.000）、淋巴结转移个数少于4个（χ^2=4.309，P=0.038）、增殖细胞核抗原（PCNA）阳性率低于25%（χ^2=10.331，P=0.000）、高中分化程度（χ^2=17.355，P=0.000）、无脉管侵袭（χ^2=9.174，P=0.002）有关。Vimentin表达于细胞质。在80例正常组中，仅有6例呈阳性表达，阳性表达率为7.50%；显著低于NSCLC组的44.68%（42/94），两组比较差异有统计学意义（χ^2=43.236，P=0.000）。Vimentin在NSCLC组中的表达与有胸膜侵袭（χ^2=8.945，P=0.003）、有淋巴结转移（χ^2=7.694，P=0.006）、淋巴结转移个数多于4个（χ^2=4.941，P=0.026）、PCNA阳性率高于25%（χ^2=5.991，P=0.014）、低分化程度（χ^2=6.479，P=0.011）和有脉管侵袭（χ^2=8.666，P=0.003）有关。经线性相关分析结果显示，NSCLC组中Vimentin及E-cadherin的表达呈负相关（r=－0.793，P=0.000）；生存期相关性分析结果显示，E-cadherin低表达、Vimentin高表达的患者预后差（P=0.017）。结论NSCLC组织中E-cadherin低表达、Vimentin高表达在肿瘤的侵袭和转移过程中起到了重要的调控作用，预示了患者预后不良，在临床上联合检测两种蛋白的表达有助于判断NSCLC的预后。

Objective To investigate the correlation between the expression levels of E-cadherin and Vimentin, and their subseguent prognostic in non-small cell lung carcinoma （NSCLC）.Methods The expression of E-cadherin and Vimentin protein levels was analyzed in 94 cases of NSCLC tissues and in 80 cases of normal lung tissues, using immunohistochemistry （IHC）. Correlation and survival analysis were used to further investigate their association and prognostic value. The correlation analysis using Pearson test, and Log-rank test for survival analysis.Results E-cadherin protein positive detection rate in NSCLC tissues was 41.49%, which was lower than those of the normal control that was 77.50% （χ^2=26.235, P=0.000）. The positive detection rate of E-cadherin was found associated with the following phenomena： no pleural invasion （χ^2=7.799, P=0.005）, no lymph mode metastasis （χ^2=17.094, P=0.000）, number of lymph node （LN） metastasis 〈4 （χ^2=4.309, P=0.038）, positive rate of proliferating cell nuclear antigen （PCNA） 〈25% （χ^2=10.331, P=0.000）, well and moderately differentiation （χ^2=17.355, P=0.000）, no vascular invasion and maximum diameter 〈5 cm （χ^2=9.174, P=0.002）. Vimentin protein positive detection rate in NSCLC tissues was 44.68%, which was higher than those of the normal control that was 7.50% （χ^2=43.236, P=0.000）. The positive detection rate of Vimentin was found associated with the following phenomena： pleural invasion （χ^2=8.945, P=0.003）, lymph mode metastasis （χ^2=7.694, P=0.006）, number of LN metastasis ≥4 （χ^2=4.941, P=0.026）, positive rate of PCNA ≥25% （χ^2=5.991, P=0.014）, poor differentiation （χ^2=6.479, P=0.011） and vascular invasion （χ^2=8.666, P=0.003）. There was a negative correlation between the protein expression of Vimentin protein and E-cadherin in NSCLC （r=-0.793, P=0.000）. Furthermore, It has been identified that the patients with low expression of E-cadherin and a higher expression of Vimentin has worse disease prognosis （P=0.017）.Conclusion The data suggest that lower expression of E-cadherin and a higher expression of Vimentin may promote occrrence and development in NSCLC and the combined detection of E-cadherin and Vimentin may be a helpful tool in predicting the prognosis of NSCLC.