血小板膜糖蛋白Ⅰbα、Ⅱb/Ⅲa和P-选择素在肺癌患者中的表达及意义

The expression of platelet glycoproteinⅠbα,Ⅱb/Ⅲa and p-selectin in lung cancer patients and its clinical significance

目的探讨肺癌患者血小板膜糖蛋白Ⅰbα、Ⅱb/Ⅲa和P-选择素的表达及其临床意义。方法在体外,分离健康志愿者及肺癌患者外周血标本,应用流式细胞术检测血小板膜糖蛋白Ⅰbα、Ⅱb/Ⅲa和P-选择素的表达;使用聚集仪检测血小板在二磷酸腺苷(ADP)、胶原蛋白(Collagen)刺激下的功能变化。结果肺癌患者的血小板膜糖蛋白Ⅰbα、Ⅱb/Ⅲa和P-选择素的平均荧光强度分别为13.94±2.69、7.67±1.89和2.84±0.60,分别高于健康志愿者的7.92±2.12、5.21±0.58和1.42±0.24,差异有统计学意义(P<0.01)。在使用ADP、Collagen刺激时,肺癌患者较健康志愿者血小板聚集率增高。肺癌Ⅲ、Ⅳ期患者血小板膜糖蛋白Ⅰbα、Ⅱb/Ⅲa和P-选择素的表达分别为14.90±2.81、8.19±1.83和2.96±0.60,高于肺癌Ⅰ、Ⅱ期患者的12.15±1.07、6.44±1.46和2.55±0.52(P<0.01);而血小板膜糖蛋白Ⅰbα、Ⅱb/Ⅲa和P-选择素的表达在肺鳞癌、小细胞肺癌、肺腺癌不同病理类型之间的差异无统计学意义(P>0.05)。结论肺癌患者血小板发生活化,且其表面膜糖蛋白水平表达增高,可能在促进肺癌细胞的远处转移中起到一定的作用。

Objective To investigate the expression of platelet glycoproteinⅠbα,Ⅱb/Ⅲa and p-selectin in lung cancer patients and their clinical significance.Methods In vitro,platelet-rich plasma(PRP)isolated from healthy controls and lung cancer patients were incubated with antibodies against Ibα,IIb/IIIa and p-selectin,and the binding was detected with FITC-conjugated goat anti-mouse antibody by flow cytometry.Platelet aggregation was induced by the addition of adenosine diphosphate(ADP)or collagen and measured by a turbidometric platelet aggregometer.Results The average fluorescence intensity of platelet membrane glycoprotein Ibα,IIb/IIIa and p-selectin in lung cancer patients were 13.94±2.69,7.67±1.89 and 2.84±0.60,respectively,which were higher than 7.92±2.12,5.21±0.58 and 1.42±0.24 in healthy volunteers(P<0.01).Platelet aggregation induced by ADD and collagen increased in lung cancer patients compared to healthy volunteers.The expression of platelet membrane glycoproteinⅠbα,Ⅱb/Ⅲa and p-selectin in patients with stageⅢ-Ⅳwere 14.90±2.81,8.19±1.83 and 2.96±0.60,respectively,which were higher than 12.15±1.07,6.44±1.46 and 2.55±0.52 in patients with stageⅠ-Ⅱ(P<0.01).There was no significant difference in the expression of platelet membrane glycoproteinⅠbα,Ⅱb/Ⅲa and p-selectin among different pathological types of lung squamous cell carcinoma,small cell lung cancer and lung adenocarcinoma(P>0.05).Conclusion The platelets are activated and the surface expression of glycoprotein is elevated in lung cancer patients,which may play a key role in promoting the distant metastasis of lung cancer.