摘要
背景与目的TTF-1和p63近年被发现在肺癌中有高表达,并可能与肺癌的发生、发展相关。本文旨在研究TTF-1和p63在非小细胞肺癌(non-small cell lung cancer,NSCLC)中的表达,并探讨其临床意义。方法收集长海医院2008年原发性NSCLC组织标本404例和良性肺疾患(benign pulmonary disease,BPD)组织标本28例,采集病例相关的临床病理资料。采用免疫组化EnVision两步法分别检测TTF-1和p63蛋白在NSCLC中的表达并对其结果进行分析。结果TTF-1和p63蛋白在NSCLC中阳性表达率分别为51.7%(209/404)和37.9%(153/404),而在BPD对照组病灶均为阴性表达。TTF-1蛋白在女性、不吸烟及无症状者升高明显(P<0.05),主要表达于肺腺癌(191/227),其诊断敏感性和特异性分别达84.1%和89.8%,阳性表达率随着腺癌分化程度的增加而增加(P<0.001)。p63蛋白阳性表达多见于男性、吸烟人群(P<0.001),对肺鳞癌的诊断敏感性高达95.5%,特异性为98.8%。p63阳性表达与鳞癌的分化程度正相关(P=0.008),与临床分期呈负相关(P=0.002),但与其他因素无关。Logistic多因素分析显示,病人吸烟史及肿瘤病理类型为影响TTF-1、p63表达的因素。两者联合检测,TTF-1(+)/p63(-)表型腺癌占93.1%,TTF-1(-)/p63(+)表型鳞癌占98.6%,TTF-1与p63的阳性表达呈负相关(r=-0.757,P<0.001)。结论NSCLC中TTF-1、p63的表达与病人吸烟史及肿瘤病理类型密切相关,二者分别是肺腺癌、鳞癌有效的生物学标志物,其联合应用有利于NSCLC的诊断及鉴别。
Background and objective To detect the expressions of thyroid transcription factor-1 （TTF-1） and p63 in non-small cell lung cancer （NSCLC） and to evaluate their clinical significance. Methods The expression ofTTF-1 and p63 from 404 NSCLC and 28 benign pulmonary disease （BPD） tissue specimens were detected by immunohistochemical EnVision two-step method, together with their clinicopathologic data. Results The positive rate ofTTF-1 and p63 protein in NSCLC tissues was 51.7% （209/404） and 37.9% （153/404）, respectively, while negative in the BPD group. There was overexpression of TTF- 1 in female gender and non-smoking history （P〈0.001） and asymptomatic patients （P=0.015）. It was more frequently in adenocarcinoma （AdC） with sensitivity of 84.1% and specificity of 89.8%, especially in well or moderately differentiated AdC （P〈0.001）. The positive rate of p63 was closely related with male gender and smoking history （P〈0.001）. Its sensitivity and specificity to squamous cell carcinoma （SCC） was 95.5% and 98.8%, respectively; which was positively correlated with differen- tiation of SCC （P=0.008）, but negatively with tumor stage （P=0.002）. Logistic multivariate analysis showed smoking history and histological type were significantly associated with T17F-1 and p63 expression. 93.1% of those represent TTF-1 （＋）/p63 （-） were AdC, while 98.6% of TTF-1（-）/p63（＋） were SCC. p63 expression was negatively correlated with TTF-1 （P〈0.001）. Conclusion TTF- 1 and p63 might be effective bio-markers for AdC and SCC in NSCLC. They may be a useful marker panel for the identification and differential of lung cancer.
出处
《中国肺癌杂志》
CAS
2009年第9期995-999,共5页
Chinese Journal of Lung Cancer
