非小细胞肺癌组织中FGF9、SMAD2表达与临床病理特征及预后的关系

Relationship between the expression of FGF9,SMAD2 and clinicopathological features,prognosis in patients with non-small cell lung cancer

目的 分析非小细胞肺癌(NSCLC)患者癌组织中成纤维细胞生长因子9(FGF9)、SMAD2表达与临床病理特征以及预后的相关性。方法 选取本院2018年1月-2020年12月收治的75例NSCLC患者作为研究对象,收集患者手术切除癌组织与癌旁组织,免疫组化法比较癌组织与癌旁组织FGF9、SMAD2蛋白表达情况,根据患者癌组织FGF9、SMAD2表达情况将患者分为FGF9阴性表达组、FGF9阳性表达组,SMAD2阴性表达组、SMAD2阳性表达组,比较组间临床病理特征差异;采用Spearman法分析FGF9与SMAD2表达相关性;构建KM曲线,分析患者FGF9、SMAD2表达与生存期的关联;通过COX法分析影响NSCLC患者预后不良的危险因素。结果 与癌旁组织相比,NSCLC组织中FGF9表达阳性率、SMAD2表达阳性率升高(P<0.05);是否发生淋巴结转移、TNM I+II期与TNM III期NSCLC患者FGF9阳性表达率比较差异有统计学意义(P<0.05);是否淋巴结转移、TNM I+II期与TNM III期、中高分化与低分化NSCLC患者SMAD2阳性表达率比较差异有统计学意义(P<0.05);NSCLC组织中蛋白FGF9、SMAD2表达呈正相关(P<0.05);随访期间FGF9阳性表达组患者累积生存率(20.8%)低于阴性表达组(77.3%),SMAD2阳性表达组患者累积生存率(25.9%)低于阴性表达组(76.5%),组间比较差异有统计学意义(P<0.05);FGF9阳性表达组患者无进展生存率(9.4%)低于阴性表达组(63.6%),SMAD2阳性表达组患者无进展生存率(15.5%)低于阴性表达组(58.8%),组间比较差异有统计学意义(P<0.05)。结论 NSCLC组织FGF9、SMAD2阳性表达升高,均与患者临床病理特征及预后相关,FGF9、SMAD2可能共同参与NSCLC的癌进展。

Objective To analyze the correlation between the expression of fibroblast growth factor 9(FGF9),SMAD2 and clinicopathological features,prognosis in patients with non-small cell lung cancer(NSCLC).Methods Seventy-five patients with NSCLC admitted to our hospital from January 2018 to December 2020 were selected as the study subjects.The tumor tissues and adjacent tissues were collected during surgical resection.The expression of FGF9 and SMAD2 proteins in cancer tissues and adjacent tissues was compared by immunohistochemistry.The patients were grouped into FGF9 negative expression group,FGF9 positive expression group,SMAD2 negative expression group and SMAD2 positive expression group according to the expression of FGF9 and SMAD2 in cancer tissues.The clinicopathological characteristics were compared between the two groups.The expression correlation between FGF9 and SMAD2 was analyzed by spearman method.KM curve was constructed to analyze the relationship between the expression of FGF9,SMAD2 and survival time;COX regression analysis was applied to analyze the risk factors of poor prognosis in NSCLC patients.Results Compared with the adjacent tissues,the positive rates of FGF9 and SMAD2 in NSCLC tissues were higher(P<0.05).There was significant difference in the positive expression rate of FGF9 between TNM I+II and TNM III NSCLC patients(P<0.05).Whether lymph node metastasis,TNM I+II and TNM III,and the positive expression rate of SMAD2 in patients with moderately differentiated and poorly differentiated NSCLC were significantly different(P<0.05).The expression of FGF9 and SMAD2 in NSCLC was positively correlated(r=0.281,P<0.05);during the follow-up period,the cumulative survival rate(20.8%) in FGF9 positive expression group was lower than that in negative expression group(77.3%).The cumulative survival rate of patients in positive SMAD2 expression group(25.9%) was lower than that of patients in negative SMAD2 expression group(76.5%)(P<0.05).The progression-free survival rate(9.4%) in the FGF9 positive expression group was lower than that in the negative expression group(63.6%),and the progression-free survival rate(15.5%) in the SMAD2 positive expression group was lower than that in the negative expression group(58.8%),and the difference between groups was statistically significant.TNM staging,positive expression of FGF9 and positive expression of SMAD2 were risk factors for poor prognosis in NSCLC patients(P<0.05).Conclusion The positive expression of FGF9 and SMAD2 is increased in NSCLC,and they are related to the clinicopathological characteristics and prognosis of patients,FGF9 and SMAD2 may jointly participate in the cancer progression of NSCLC.