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目的 前瞻性探讨抑癌基因 p5 3,癌基因K ras、HER2 ,血管内皮生长因子 (VEGF) ,表皮生长因子受体 (EGFR) ,粘连因子CD4 4 ,金属蛋白酶MMP9等蛋白表达对ⅢA期非小细胞肺癌 (NSCLC)术后复发转移和生存期的影响。方法 采用免疫组织化学方法检测 32例ⅢA期非小细胞肺癌手术标本中上述蛋白表达。结果 p5 3、K ras、VEGF、EGFR、CD4 4、MMP9和HER2蛋白表达率分别为 6 2 .5 % (2 0 / 32 )、34.3% (11/ 32 )、2 5 .0 % (8/ 32 )、4 6 .9% (15 / 32 )、78.1% (2 5 / 32 )、5 0 % (16 / 32 )和4 3.8% (14 / 32 )。K ras,EGFR蛋白表达与疾病进展时间 (timetoprogression ,TTP)有关 (P =0 .0 30 ,P =0 .0 0 8)。多变量Cox回归分析 ,K ras,HER2蛋白表达是影响生存期的独立影响因素。Kaplan M生存分析显示K ras,HER2阳性组生存期明显短于阴性组 (P =0 .0 4 2 ,P =0 .0 39)。结论 对于ⅢA期NSCLC ,上述 7种因子阳性表达率很高。K ras,EGFR蛋白表达阳性患者术后更易发生远处转移 ,K ras ,HER2表达是影响生存期的独立影响因素。
Objective To investigate the expression of tumor suppressor gene p53, K ras, HER2, VEGF, EGFR, adhesion molecule CD4 4 and metalloproteinase MMP9 in non-small Effect of postoperative recurrence, metastasis and survival of patients with lung cancer (NSCLC). Methods Immunohistochemistry was used to detect the above protein expression in 32 patients with stage ⅢA non-small cell lung cancer. Results The expression rates of p53, Kras, VEGF, EGFR, CD4 4, MMP9 and HER2 were 62.5% (20/32), 34.3% (11/32), 25.0% 32), 46.9% (15/32), 78.1% (25/32), 50% (16/32) and 48.8% (14/32). K ras, EGFR protein expression and disease progression time (timetoprogression, TTP) (P = 0.30, P = 0.080). Multivariate Cox regression analysis showed that K ras and HER2 protein expressions were independent influencing factors of survival. Survival analysis of Kaplan M showed that survival in K ras and HER2 positive patients was significantly shorter than that in negative patients (P = 0.042, P = 0.039). Conclusions The positive rate of the above seven factors is very high for stage Ⅲ A NSCLC. K ras and EGFR protein positive patients were more likely to distant metastasis after surgery, K ras, HER2 expression is an independent factor affecting survival.