Yang Xin, Xue Liyan, Guo Lei, Wen Peng, Lin Dongmei
Department of Pathology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
Zhongguo Fei Ai Za Zhi. 2014 Mar;17(3):243-53. doi: 10.3779/j.issn.1009-3419.2014.03.11.
Lung adenocarcinoma is one of the most common histological subtypes of lung cancer. The incidence of this disease was continuously increased. This study aims to detect the expressions of Napsin A, TTF-1, ERCC1, RRM1, EGFR, HER2, ERα, ERβ, PR, and Bcl-2 in lung adenocarcinoma and to explore their correlations with clinicopathological characteristics and prognosis.
A total of 227 lung adenocarcinoma specimens were constructed in tissue microarrays. The expressions of the 10 tumor biomarkers were analyzed by immunohistochemistry on paraffin-embedded sections.
Among the 10 markers, Napsin A was gender-related (P=0.049). Napsin A, PR, and EGFR were significantly associated with smoking. TTF-1 and ERCC1 were closely associated with tumor size. Napsin A, TTF-1, ERα, and PR were remarkably associated with tumor differentiation. TTF-1, Bcl-2, and ERCC1 were closely associated with tumor stage (P<0.05). No marker was related to age. No correlations were observed between ERβ, HER2, and RRM1 expressions and clinicopathological parameters (P>0.05). Univariate analysis results showed that Napsin A, TTF-1, and ERCC1 were significantly associated with overall survival. TTF-1 was remarkably associated with disease-free survival (P<0.05). Stage I cases were further analyzed and revealed that only Napsin A expression was associated with overall survival (P<0.05). No marker was correlated with disease-free survival (P>0.05). Multivariate analysis results showed that pathological staging was significantly associated with overall survival and disease-free survival (P<0.05). No marker was identified as a predictor of patient outcome (P>0.05).
Napsin A, TTF-1, and ERCC1 are the markers indicating good prognosis of lung adenocarcinoma.
肺腺癌是肺癌最常见的组织学亚型之一。该疾病的发病率持续上升。本研究旨在检测Napsin A、甲状腺转录因子-1（TTF-1）、切除修复交叉互补基因1（ERCC1）、核糖核苷酸还原酶M1（RRM1）、表皮生长因子受体（EGFR）、人表皮生长因子受体2（HER2）、雌激素受体α（ERα）、雌激素受体β（ERβ）、孕激素受体（PR）和Bcl-2在肺腺癌中的表达，并探讨它们与临床病理特征及预后的相关性。
共构建227例肺腺癌组织芯片标本。采用免疫组织化学方法在石蜡包埋切片上分析10种肿瘤生物标志物的表达。
在这10种标志物中，Napsin A与性别相关（P=0.049）。Napsin A、PR和EGFR与吸烟显著相关。TTF-1和ERCC1与肿瘤大小密切相关。Napsin A、TTF-1、ERα和PR与肿瘤分化显著相关。TTF-1、Bcl-2和ERCC1与肿瘤分期密切相关（P<0.05）。无标志物与年龄相关。未观察到ERβ、HER2和RRM1表达与临床病理参数之间存在相关性（P>0.05）。单因素分析结果显示，Napsin A、TTF-1和ERCC1与总生存期显著相关。TTF-1与无病生存期显著相关（P<0.05）。对I期病例进一步分析发现，只有Napsin A表达与总生存期相关（P<0.05）。无标志物与无病生存期相关（P>0.05）。多因素分析结果显示，病理分期与总生存期和无病生存期显著相关（P<0.05）。未发现有标志物可作为患者预后的预测指标（P>0.05）。
Napsin A、TTF-1和ERCC1是提示肺腺癌预后良好的标志物。
