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目的硫氧还蛋白还原酶(thioredoxin reductase,TrxR)是肿瘤相关性蛋白,其在肿瘤细胞的增殖和分化中起着重要的作用。本研究探讨TrxR在非小细胞肺癌(non-small cell lung cancer,NSCLC)中的表达及对预后的影响。方法免疫组化法检测潍坊市人民医院胸外科2013-02-01-10-30 87例NSCLC组织和20例癌旁正常组织中TrxR的表达,分析其与临床病理参数之间的关系,并随访患者生存时间进行分析。结果肺癌组织TrxR阳性率为93.1%(81/87),癌旁组织中阳性率为20.0%(4/20),差异有统计学意义,χ2=52.710,P<0.01。低分化癌组织TrxR表达高于中、高分化癌组织,差异有统计学意义,χ2=11.876,P=0.03。有淋巴结转移组TrxR表达高于无淋巴结转移组,差异有统计学意义,χ2=5.471,P=0.02。TNM分期中Ⅲ~Ⅳ期TrxR的表达明显高于Ⅰ、Ⅱ期中的表达,差异有统计学意义,χ2=4.711,P=0.03。TrxR的表达水平与患者的性别、年龄、吸烟史和病理分型无明显相关性。Kaplan-Meier生存分析结果显示,TrxR高表达组患者预后更差,χ2=6.467,P=0.01。多因素Cox回归分析显示,TrxR是危险因素,P<0.01。结论 TrxR在NSCLC中高表达并提示预后不良。
Objective Thioredoxin reductase (TrxR) is a tumor-associated protein that plays an important role in the proliferation and differentiation of tumor cells. This study was to investigate the expression of TrxR in non-small cell lung cancer (NSCLC) and its prognostic impact. Methods The expression of TrxR in 87 NSCLC tissues and 20 adjacent normal tissues was detected by immunohistochemistry in Weifang People’s Hospital of Thoracic Surgery. The relationship between the expression of TrxR and clinicopathological parameters was analyzed and followed up Patient survival time analysis. Results The positive rate of TrxR in lung cancer tissues was 93.1% (81/87), and the positive rate in adjacent tissues was 20.0% (4/20). The difference was statistically significant (χ2 = 52.710, P <0.01). The expression of TrxR in poorly differentiated cancer tissues was higher than that in moderately differentiated cancer tissues, the difference was statistically significant (χ2 = 11.876, P = 0.03). The expression of TrxR in lymph node metastasis group was higher than that in non-lymph node metastasis group, the difference was statistically significant (χ2 = 5.471, P = 0.02). The expression of TrxR in stage Ⅲ ~ Ⅳ was significantly higher than that in stage Ⅰ and Ⅱ in TNM staging, the difference was statistically significant (χ2 = 4.711, P = 0.03). There was no significant correlation between the expression level of TrxR and the gender, age, smoking history and pathological type. Kaplan-Meier survival analysis showed that patients with high expression of TrxR had worse prognosis, χ2 = 6.467, P = 0.01. Multivariate Cox regression analysis showed that TrxR was a risk factor, P <0.01. Conclusion TrxR is highly expressed in NSCLC and suggests a poor prognosis.