摘要
目的探讨天冬氨酸肽酶A(Napsin A),鞘氨醇-1-磷酸(sphingosine-1-phosphate,S1P)及其受体1(sphingosine1-phosphatereceptor-1,S1PR1)在肺腺癌恶性胸腔积液(malignant pleural effusion,MPE)中的表达及其临床意义。方法在60例肺腺癌MPE患者中,通过ELISA法检测S1P水平、采用免疫组织化学(immunohistochemistry,IHC)染色检测Napsin A和S1PR1的蛋白表达。评估其表达与患者临床病理特征的相关性,并运用单、多因素Logistic回归分析确定影响预后的独立危险因素。结果预后不良组患者胸腔积液中S1P表达显著高于预后良好组(P<0.001)。胸腔积液脱落细胞蜡块IHC评分显示,预后不良组S1PR1表达的IHC评分显著升高(P<0.05)。在预后危险因素分析中,单因素分析提示S1P,S1PR1高表达和胸膜侵犯是预后不良的危险因素,多因素Logistic回归分析进一步证实,S1P高表达(OR=1.018,95%CI:1.005~1.032,P=0.009),S1PR1高表达(OR=1.458,95%CI:1.098~1.936,P=0.009)与胸膜侵犯(OR=7.509,95%CI:1.684~33.486,P=0.008)为肺腺癌MPE患者预后的独立危险因素。结论S1P和S1PR1在肺腺癌MPE中表达上调,二者高表达及胸膜侵犯与患者预后密切相关。联合检测S1P和S1PR1可作为评估肺腺癌MPE患者预后的重要指标。
Objective To investigate the expression and clinical significance of Napsin A,sphingosine-1-phosphate(S1P),and sphingosine-1-phosphate receptor-1(S1PR1)in malignant pleural effusion(MPE)of adenocarcinoma-type non-small cell lung cancer.Methods In 60 patients with lung adenocarcinoma MPE,S1P levels were measured by ELISA,and protein expression of Napsin A and S1PR1 was detected by immunohistochemistry(IHC)staining.The correlation between their expression and patients′clinicopathological characteristics was evaluated,and univariate and multivariate logistic regression analyses were performed to identify independent prognostic risk factors.Results The study found that S1P expression in pleural effusion was significantly higher in the poor prognosis group compared to the good prognosis group(P<0.001).IHC scoring of exfoliated cell paraffin blocks from pleural effusion revealed significantly elevated S1PR1 expression scores in the poor prognosis group(P<0.05).In the analysis of prognostic risk factors,univariate analysis indicated that high expression of S1P,S1PR1,and pleural invasion were risk factors for poor prognosis.Multivariate logistic regression analysis further confirmed that high S1P expression(OR=1.018,95%CI:1.005-1.032,P=0.009),high S1PR1 expression(OR=1.458,95%CI:1.098-1.936,P=0.009),and pleural invasion(OR=7.509,95%CI:1.684-33.486,P=0.008)were independent risk factors for the prognosis of adenocarcinoma-type MPE patients.Conclusion S1P and S1PR1 are upregulated in MPE of lung adenocarcinoma.High expression of both and pleural invasion are closely associated with poor patient prognosis.Combined detection of S1P and S1PR1 can serve as an important indicator for evaluating the prognosis of patients with adenocarcinoma-type MPE.
作者
钱倩
王权
景楚微
QIAN Qian;WANG Quan;JING Chuwei(Jiangsu Vocational College of Health and Wellness,Nanjing,Jiangsu 211800,China;Yifu Hospital Affiliated to Nanjing Medical University,Nanjing,Jiangsu 211100,China;Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China)
出处
《临床肺科杂志》
2025年第9期1321-1327,共7页
Journal of Clinical Pulmonary Medicine
基金
江苏省卫生健康委员会面上项目(JSHD2022048),江苏卫生健康职业学院校级课题重大项目(JKA2021002)。
