Whitney J F, Clark J M, Griffin T W, Gautam S, Leslie K O
Department of Pathology, University of Vermont, Burlington 05405-0068, USA.
Cancer. 1995 Jul 1;76(1):20-5. doi: 10.1002/1097-0142(19950701)76:1<20::aid-cncr2820760104>3.0.co;2-3.
In the search for tumor-related antigens with survival-predictive value, previous studies have yielded varied conclusions regarding the expression of one such antigen, the transferrin receptor in lung cancer. The goal of this study was to define the frequency of expression of transferrin receptor in lung cancer specimens and gather preliminary data regarding the prognostic value of this tumor-related antigen.
Tissue immunoreactivity was studied with a murine monoclonal antibody to transferrin receptor in patients with nonsmall cell lung cancer who underwent surgical resection at the Medical Center Hospital of Vermont during the period from January, 1988, to May, 1991.
The study group consisted of 32 patients (21 males and 11 females) with an average follow-up length of 27 months (standard deviation of 16 months). There were 17 patients with adenocarcinoma, 14 with squamous cell carcinoma, and 1 with large cell carcinoma. At the end of data accumulation, a total of 16 deaths had been recorded (8 with squamous cell, 8 with adenocarcinoma). Normal lung tissue did not stain for transferrin receptor; however, 13 of 17 (76%) adenocarcinomas, 13 of 14 (93%) squamous cell carcinomas, and the 1 large cell carcinoma stained positively for transferrin receptor. Staining for transferrin receptor was graded according to pattern and intensity and categorized as absent-weak or strong. Survival analysis was performed to evaluate patient outcome based on a variety of clinical and experimentally determined characteristics. Groups based on N-status (N0 vs. N1 + N2, P = 0.08), stage (Stage 1 vs. Stage 2 + 3 P = 0.13), age (younger than 60 vs. 60 years or older, P = 0.09), and transferrin receptor staining (absent-weak vs. strong, P = 0.14) achieved nearly significant differences in survival. Further analysis of the differences in survival for groupings based on transferrin receptor staining found that these differences in survival reached significance for patients with larger tumors (T2 or T3, P = 0.02).
Transferrin receptor is expressed in the majority of lung cancers and the presence of transferrin receptor in nonsmall cell lung cancers may be an indicator of poorer prognosis in certain groups of patients.
在寻找具有生存预测价值的肿瘤相关抗原的过程中，以往关于肺癌中一种此类抗原——转铁蛋白受体表达的研究得出了不同的结论。本研究的目的是确定肺癌标本中转铁蛋白受体的表达频率，并收集有关这种肿瘤相关抗原预后价值的初步数据。
对1988年1月至1991年5月期间在佛蒙特州医学中心医院接受手术切除的非小细胞肺癌患者，用抗转铁蛋白受体的鼠单克隆抗体研究组织免疫反应性。
研究组由32例患者（21例男性和11例女性）组成，平均随访时间为27个月（标准差为16个月）。其中腺癌17例，鳞状细胞癌14例，大细胞癌1例。在数据积累结束时，共记录到16例死亡（鳞状细胞癌8例，腺癌8例）。正常肺组织中转铁蛋白受体不染色；然而，17例腺癌中有13例（76%）、14例鳞状细胞癌中有13例（93%）以及1例大细胞癌中转铁蛋白受体染色呈阳性。根据模式和强度对转铁蛋白受体染色进行分级，并分为无-弱或强。基于各种临床和实验确定的特征进行生存分析以评估患者预后。基于N状态（N0与N1 + N2，P = 0.08）、分期（1期与2 + 3期，P = 0.13）、年龄（小于60岁与60岁及以上，P = 0.09）和转铁蛋白受体染色（无-弱与强，P = 0.14）分组在生存方面几乎有显著差异。基于转铁蛋白受体染色分组对生存差异的进一步分析发现，对于较大肿瘤（T2或T3）患者，这些生存差异具有显著性（P = 0.02）。
转铁蛋白受体在大多数肺癌中表达，非小细胞肺癌中转铁蛋白受体的存在可能是某些患者群体预后较差的一个指标。
