非小细胞肺癌中转录因子Snail及其相关蛋白表达的临床研究

Clinical study on expressions of transcription factor Snail and its related proteins in non-small cell lung cancer

目的探讨非小细胞肺癌（NSCLC）中转录因子Snail和上皮钙黏素（E．cad）、神经钙黏素（N．cad）的表达及三者之间的关系。方法选取新疆医科大学附属肿瘤医院2014年1月至2015年12月有完整临床病理资料的59例NSCLC患者及3 1例肺良性病变患者术后组织标本，采用免疫组织化学法检测癌组织及癌旁正常组织、肺良性病变组织中Snail与N-cad、E-cad的表达，分析其与临床病理特征间的关系，并进一步分析Snail与N．cad、E．cad在NSCLC组织中表达的相互关系。结果NSCLC组织中Snail、N-cad的阳性率均高于癌旁正常组织及肺良性病变组织[81．4％（48／59）比37-3％（22／59）比12．9％（4／31），×0=9．782，P〈0．05；76．3％（45／59）比33．9％（20／59）比12．9％（4／31），χ^2=7．445，P〈0．05]，而E-cad阳性率低于癌旁正常组织及肺良性病变组织[20_3％（12／59）比55．9％（33／59）比93．5％（29／31），x。45．107，P〈0．叭]。NSCLC中，Snail阳性率在有无淋巴结转移间及TNM分期I、Ⅱ、ⅢA期间差异有统计学意义[97．5％（39／40）比47．4％（9／19），χ^2=7．734，P〈0．05；12．5％（1／8）比81．0％（17／21）比100．0％（30／30），χ^2=7．723，P〈0．05]，E-cad阳性率差异也有统计学意义[95．0％（38／40）比36．8％（7／19），χ^2=7．190，P〈0．05；100．0％（8／8）比19．0％（4／21）比0（0／30），χ^2=12．311，P〈0．01]，N-cad阳性率在有无淋巴结转移间，高、中、低分化间及TNM分期I、Ⅱ、Ⅲ^期间差异有统计学意义[97．5％（39／40）比47．4％（9／19），x。=11．231，P〈0．01；28．6％（2／7）比63．6％（14／22）比96．7％（29／30），x。=9．564，P〈0．05；12．5％（1／8）比85．7％（18／21）比86．7％（26／30），x。11．664，P〈0．01]。NSCLC组织中，Snail和E-cad表达、E．cad和N-cad表达均呈负相关（r=-0．667，P=0．00；r=-0．297，P=0．01），Snail和N-cad表达呈正相关（r=0．373，P〈0．01）。结论Snail、E-cad和N-cad与NSCLC的发生、进展和转移有关，联合检测可预测肿瘤浸润、转移和预后。

Objective To detect the expressions of transcription factor Snail, E-cadherin （E-cad） and N-cadherin （N-cad） in non-small cell lung cancer （NSCLC）, and explore their correlations. Methods The expression patterns of Snail, E-cad and N-cad in human lung tissues were detected by immunohistochemistry, from 59 untreated NSCLC patients in Affiliated Cancer Hospital of Xinjiang Medical University from January 2014 to December 2015 for whom clinical data were available, with adjacent tissues and 31 benign lesions as control. The expression patterns of Snail, E-cad, N-cad and clinicopathological factors were analyzed. Results The positive rate of Snail and N-cad in NSCLC was significantly higher than those in the control tissues [81.4 % （48/59） vs. 37.3 % （22/59） vs. 12.9 % （4/31）, χ^2 = 9.782, P 〈 0.05; 76.3 % （45/59） vs. 33.9 % （20/59） vs. 12.9 % （4/31）, χ^2 = 7.445, P 〈 0.05]. The positive rate of E-cad in NSCLC was significantly lower than those in the control tissues [20.3 % （12/59） vs. 55.9 % （33/59） vs. 93.5 % （29/31）,χ^2 = 45.107, P 〈 0.01].The expressions of Snail and E-cad were related to lymph node metastasis and TNM stage [snail： 97.5 % （39/ 40） vs. 47.4 % （9/19）, χ^2 = 7.734, P 〈 0.05; 12.5 % （1/8） vs. 81.0 % （17/21） vs. 100.0 % （30/30）, χ^2 = 7.723, P 〈 0.05; E-cad： 95.0 % （38/40） vs. 36.8 % （7/19）, χ^2= 7.190, P 〈 0.05; 100.0 % （8/8） vs. 19.0 % （4/21） vs. 0 （0/30）, χ^2= 12.311, P 〈 0.01]. The expression of N-cad was related to lymph node metastasis, histological grade and TNM stage [97.5 % （39/40） vs. 47.4 % （9/19）, χ^2= 11.231, P〈 0.01; 28.6 % （2/7） vs. 63.6 % （14/22） vs. 96.7 % （29/30）, χ^2 = 9.564, P〈 0.05; 12.5 % （1/8） vs. 85.7 % （18/21） vs. 86.7 % （26/30）, χ^2 = 11.664, P 〈 0.01]. The positive correlation was found between Snail and N-cad （r = 0.373, P 〈 0.01）, the negative correlation was found between the expression of Snail and E-cad, N-cad and E-cad （r = -0.667, P = 0.00; r = -0.297, P = 0.01）. Conclusion Snail, E-cad and N-cad are involved in the development, progression and metastasis of NSCLC, and combined detection can predict tumor invasion, metastasis and prognosis.