Department of Respiratory Medicine, Kitasato University, Kanagawa, Japan.
Department of Molecular Diagnostics, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.
Chest. 2011 Apr;139(4):862-869. doi: 10.1378/chest.10-1121. Epub 2010 Sep 9.
Nestin is a class 6 intermediate filament protein expressed in stem/progenitor cells during CNS development. Nestin expression has been detected in many kinds of tumors and was reported in a recent small-scale study in non-small cell lung cancer (NSCLC). We investigated the relationships between nestin expression and clinicopathologic parameters and determined its prognostic significance concerning survival in patients with resected NSCLC.
Nestin expression in tumor cells was studied immunohistochemically in 171 consecutive patients with NSCLC, and associations with clinicopathologic parameters were evaluated. Kaplan-Meier survival analysis and Cox proportional hazards models were used to estimate the effect of nestin expression on survival.
Nestin expression was observed in tumor cell samples in 27 of the 171 patients with NSCLC (15.8%). Nestin had only cytoplasmic expression. Clinicopathologically, nestin expression was significantly associated with squamous cell carcinoma (P = .001), poorer differentiation (P = .007), lymph node metastasis (P = .008), intratumoral vascular invasion (P = .003), intratumoral lymphatic invasion (P = .008), pleural invasion (P = .039), and poorer prognosis (P < .001). Multivariable analysis confirmed that nestin expression increased the hazard of death after adjusting for other clinicopathologic factors (hazard ratio, 2.75; 95% CI, 1.39-5.46).
The present study suggests that nestin expression is a prognostic indicator of poorer survival probability for patients with resected NSCLC and may be used as a potential marker for select patients who should receive adjuvant chemotherapy.
巢蛋白是中枢神经系统发育过程中干细胞/祖细胞中表达的 6 类中间丝蛋白。巢蛋白的表达已在许多种肿瘤中被检测到，并在最近一项非小细胞肺癌（NSCLC）的小规模研究中报道。我们研究了巢蛋白表达与临床病理参数之间的关系，并确定了其在接受 NSCLC 根治性手术的患者的生存预后方面的意义。
我们采用免疫组织化学方法检测了 171 例连续 NSCLC 患者肿瘤细胞中的巢蛋白表达情况，并评估了其与临床病理参数的关系。Kaplan-Meier 生存分析和 Cox 比例风险模型用于估计巢蛋白表达对生存的影响。
在 171 例 NSCLC 患者中，有 27 例（15.8%）肿瘤细胞样本中观察到巢蛋白表达。巢蛋白仅呈细胞质表达。临床病理上，巢蛋白表达与鳞状细胞癌（P=0.001）、分化较差（P=0.007）、淋巴结转移（P=0.008）、肿瘤内血管侵犯（P=0.003）、肿瘤内淋巴管侵犯（P=0.008）、胸膜侵犯（P=0.039）和预后较差（P<0.001）显著相关。多变量分析证实，巢蛋白表达增加了调整其他临床病理因素后的死亡风险（风险比，2.75；95%可信区间，1.39-5.46）。
本研究表明，巢蛋白表达是 NSCLC 根治性手术后患者生存概率较差的预后指标，可能被用作选择应接受辅助化疗的患者的潜在标志物。
