摘要
目的 观察肺特异性X蛋白（LUNX）在PN0期非小细胞肺癌（NSCLC）原发病灶和转移淋巴结中的表达,探讨LUNX在PN0期NSCLC淋巴结微转移中的作用.方法 收集我院经手术切除且病理检查证实的52例PN0期NSCLC病例,记录各患者性别、年龄、吸烟史、肿瘤性质、浸润程度、淋巴结微转移及TNM分期等临床各项资料.将切除的肿瘤标本和清扫的淋巴结标本,行免疫组织化学染色,并提取肿瘤和淋巴结组织的DNA行聚合酶链反应（PCR）扩增和测序,观察LUNX在PN0期NSCLC原发病灶和转移淋巴结中的表达,并分析临床病理特征和患者术后总体生存的关系.结果 （1） LUNX mRNA在52例肺癌病例的原发灶均表达阳性（100％）,327站淋巴结中49站（14.98％）表达阳性,196站纵隔淋巴结中24站（12.24％）表达阳性.（2）影响术后生存和无病生存率的因素包括：LUNX分期（P＜0.01）、纵隔淋巴结微转移（P＜0.01）、清扫淋巴结总站数（P＜0.01）、清扫纵隔淋巴结站数（P＜0.05）、病理分级（P＜0.05）.（3）纵隔淋巴结微转移是影响术后无病生存的唯一独立危险因素,有纵隔淋巴结微转移的患者的复发风险是无纵隔淋巴结微转移的患者的21.8倍（P＜0.01）.结论 通过对PN0期NSCLC原发肿瘤病灶LUNX mRNA蛋白表达的检测,研究其与淋巴结微转移以及患者预后的关系.可以更加精确地预测早期NSCLC患者的预后,减少术后治疗的盲目性,改善疗效.
Objective To investigate the detection of lymph node micrometastasis in stage Ⅰ nonsmall cell lung cancers （NSCLC） using lung-specific X protein （LUNX） mRNA as a marker based on reverse transcription-polymerase chain reaction （RT-PCR） and its relationship with the patho-clinical features and prognosis.Methods 52 patients underwent curative lobectomy,excluding pneumonectomy and Palliative resection.Curative lobeetomy included systemic lymph node reseetion,Which meant at least 6 mediastinal lymph node from 3 stations were reseeted.The expression of LUNX mRNA in each station of lymph node were examined by means of RT-PCR.LUNX mRNA was then used as a marker of lymph node micrometastasis.Analyses of relationship between lymph node micrometastasis and the pathoclinical features,overall survival and disease free survival were then carried out.Results The expression of LUNX mRNA：none was positive for all ten lymph nodes from benign diseases.All 52 lung cancer tissues showed positive expression,14.98% of lymph nodes and 12.24% of mediastinal lymph nodes showed positive expression,so that the LUNX stage was upgraded.Survival affecting factors included：LUNX stage （P 〈 0.01）,mediastinal lymph nodes micrometastasis （P 〈 0.01）,number of lymph nodes and mediastinal lymph nodes resected （P 〈 0.05）,pathological differentiation （P 〈 0.05）.Those with mediastinal lymph nodes micrometastasis had a 21.8 folds higher risk of death than those without （P 〈 0.01）.Conclusion The expression of LUNX mRNA in lymph nodes is related to overall survival and disease free survival,and is a reflection of lymph nodes micrometastasis.The subgroup of stage propidium iodide （PI） patients with high risks can be thus found.This technique is helpful in restaging patients more accurately.Survival can be improved if interference is applied in early stage.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2014年第11期2592-2595,共4页
Chinese Journal of Experimental Surgery
基金
嘉兴市科技计划项目（2013AY21054-2）
关键词
非小细胞肺癌
肺特异性X蛋白
淋巴结微转移
生存率
Non-small cell lung cancer
Lung-specific X protein
Lymphatic metastasis
Survival rate
