Mathieu Anne, Saal Isabelle, Vuckovic Aline, Ransy Valérie, Vereerstraten Pierre, Kaltner Herbert, Gabius Hans-Joachim, Kiss Robert, Decaestecker Christine, Salmon Isabelle, Remmelink Myriam
Department of Pathology, Erasmus Hospital, Free University of Brussels (ULB), Brussels, Belgium.
Mod Pathol. 2005 Sep;18(9):1264-71. doi: 10.1038/modpathol.3800416.
The tumor stage is the most powerful prognostic tool for predicting the survival rates of lung carcinoma patients. However, prognosis of individual patients is difficult in part because of the marked clinical heterogeneity among such patients. Galectins are involved in cell growth, apoptosis and cell migration features, and their diagnostic and prognostic values have already been demonstrated in various types of cancers. In the present paper we analyze the potential prognostic value of immunohistochemical galectin-3 expression in lung adenocarcinomas and squamous cell carcinomas. In all, 165 squamous cell carcinomas and 121 adenocarcinomas were immunostained for galectin-3. In each case the immunohistochemical analyses consisted of an evaluation of the percentage of tumor cells stained and the intensity of staining. An IP score (ie Intensity x Percentage) was thus determined for each lung carcinoma. A large majority of cases displayed galectin-3 expression. While the cytoplasmic staining in the squamous cell carcinomas was focal and moderately intense, the staining in the adenocarcinomas was diffuse and intense. The IP scores were significantly (P=0.0001) higher in the adenocarcinomas than in the squamous cell carcinomas. The difference in nuclear expression profiles between the two cancer types was statistically significant (P=0.0005). Cox multivariate analysis carried out on the patients' genders, the TNM classification and the galectin-3-related variables showed that of the galectin-3-related variables, only the nuclear location of galectin-3 was identified as a prognostic indicator of recurrence independent of the clinicopathological features characterizing the patients (P=0.02). The prognostic contribution of this latter variable was enhanced when the patients with relapse-free follow-ups longer than 8 months were considered (P=0.005). Galectin-3 immunohistochemical expression differs between squamous cell carcinomas and adenocarcinomas, but the nuclear expression of galectin-3 behaves as a significant prognostic predictor for all the cases as a group.
肿瘤分期是预测肺癌患者生存率最有效的预后工具。然而,个体患者的预后难以判断,部分原因是这类患者存在显著的临床异质性。半乳糖凝集素参与细胞生长、凋亡和细胞迁移过程,其诊断和预后价值已在多种癌症中得到证实。在本文中,我们分析了免疫组化检测半乳糖凝集素-3表达在肺腺癌和肺鳞状细胞癌中的潜在预后价值。总共对165例肺鳞状细胞癌和121例肺腺癌进行了半乳糖凝集素-3免疫染色。在每个病例中,免疫组化分析包括评估肿瘤细胞染色的百分比和染色强度。由此确定了每个肺癌的IP评分(即强度×百分比)。绝大多数病例显示半乳糖凝集素-3表达。肺鳞状细胞癌的细胞质染色呈局灶性且强度适中,而肺腺癌的染色呈弥漫性且强度较高。肺腺癌的IP评分显著高于肺鳞状细胞癌(P = 0.0001)。两种癌症类型之间核表达谱的差异具有统计学意义(P = 0.0005)。对患者性别、TNM分期和与半乳糖凝集素-3相关的变量进行Cox多因素分析,结果显示,在与半乳糖凝集素-3相关的变量中,只有半乳糖凝集素-3的核定位被确定为独立于患者临床病理特征的复发预后指标(P = 0.02)。当考虑无复发生存期超过8个月的患者时(P = 0.005),后一个变量的预后作用增强。肺鳞状细胞癌和肺腺癌之间半乳糖凝集素-3免疫组化表达不同,但作为一个整体,半乳糖凝集素-3的核表达对所有病例而言都是一个显著的预后预测指标。