Nrf2在非小细胞肺癌中的表达及临床意义

Expression and clinical significance of Nrf2 in non-small cell lung cancer

目的探讨核转录因子E2相关因子2(Nrf2)在非小细胞肺癌(NSCLC)中的表达及临床意义。方法回顾性选取2013年7月至2016年12月在辽宁省肿瘤医院治疗的NSCLC患者组织标本72例,同时选取癌旁组织(距癌组织> 5 cm)标本作为对照。采用免疫组化染色和逆转录-聚合酶链反应(RT-PCR)检测Nrf2蛋白表达和mRNA表达,观察其与临床病理特征及预后的关系。结果 NSCLC组织Nrf2阳性表达率和Nrf2 mRNA表达分别为62. 50%和(1. 392±0. 223),明显高于癌旁组织(P <0. 05);肿瘤直径> 5 cm、TNM分期为Ⅲ～Ⅳ期、有淋巴结转移患者Nrf2蛋白阳性表达率分别为87. 88%、86. 36%和76. 19%,明显高于肿瘤直径≤5 cm、Ⅰ～Ⅱ期、无淋巴结转移患者(P <0. 05); Nrf2mRNA表达与患者临床病理特征无关(P> 0. 05); Nrf2蛋白表达和Nrf2 mRNA表达呈正相关(r_s=0. 366,P <0. 05);Nrf2蛋白阳性表达患者中位无进展生存时间和总生存时间分别为12个月(95%CI:9. 92～14. 08)和21个月(95%CI:19. 76～22. 25),明显低于Nrf2蛋白阴性表达者(P <0. 05)。结论 Nrf2在NSCLC患者中的表达明显升高,其与临床病理特征及预后有一定关系,值得进一步研究。

Objective To investigate the expression and clinical significance of Nrf2 in non-small cell lung cancer.Methods 72 specimens of NSCLC patients who were treated in our hospital from July 2013 to December 2016 were selected and the para cancerous tissue(From the cancer﹥5 cm)was selected as the control,the expression of Nrf2 protein and Mrna was detected by immunohistochemical staining and RT-PCR,and the relationship with the clinicopathological features and prognosis was compared.Results The positive expression rate of Nrf2 and mRNA in NSCLC tissue were 62.50%and 1.392±0.223,which were significantly higher than that of para cancerous tissue(P﹤0.05).The expression of Nrf2 protein in patients with tumor diameter﹥5 cm,TNM stage III-IV stage,lymph node metastasis were 87.88%,86.36%and 76.19%,significantly higher than the tumor diameter≤5 cm,I^II,without lymph node metastasis(P﹤0.05).The expression of Nrf2 mRNA was not related to the clinicopathological features of the patients(P﹥0.05).The expression of Nrf2 protein was positively correlated with the expression of Nrf2 mRNA(rs=0.366,P﹤0.05).The median progression free survival time and overall survival time in patients with positive expression of Nrf2 protein were 12 months(95%CI:9.92~14.08)and 21 months(95%CI:19.76~22.25),which were significantly lower than that of negative expression of Nrf2 protein(P﹤0.05).Conclusion The expression of Nrf2 in NSCLC is obviously elevated,which has a certain relationship with the clinicopathological features and prognosis of the patients,is worth further study.