Lai W W, Wu M H, Yan J J, Chen F F
Department of Surgery, National Cheng Kung University Hospital, Taiwan, Republic of China.
Ann Thorac Surg. 1996 Nov;62(5):1500-4. doi: 10.1016/0003-4975(96)00603-0.
About 30% to 40% of patients with pathologic stage I non-small cell lung cancer die within 5 years after complete resection. The identification of subgroups with high risk of recurrence is important. The level of nm23-H1/nucleoside diphosphate kinase expression has been reported to correlate inversely with the metastatic potential of some tumors.
We examined immunohistochemically the expression of nm23-H1 in 32 stage I non-small cell lung cancers to determine its value in predicting the outcome of the operation.
Twelve (37.5%) recurrences and ten deaths occurred in this series. There were eight (25%) distant and four (12.5%) locoregional recurrences. Of the 32 pathologic stage I non-small cell lung cancers, 10 (31.3%) were positive for nm23-H1 gene product. None of the patients with a higher nm23-H1 protein level had detectable distant metastases at the end of this study (chi 2 test, p < 0.05). The median follow-up time to date is only 35 months (range, 18 to 83 months), and so far no significant difference in overall survival rate has been observed between the groups with high and low nm23-H1 protein levels.
The level of nm23-H1 protein is more useful than the T status or histologic type for the prediction of distant metastases, whereby cases may be selected for postoperative adjuvant chemotherapy.
病理分期为I期的非小细胞肺癌患者中，约30%至40%在完全切除术后5年内死亡。识别具有高复发风险的亚组很重要。据报道，nm23-H1/核苷二磷酸激酶的表达水平与某些肿瘤的转移潜能呈负相关。
我们对32例I期非小细胞肺癌进行了nm23-H1表达的免疫组化检测，以确定其在预测手术结果中的价值。
该系列中有12例（37.5%）复发，10例死亡。有8例（25%）远处复发和4例（12.5%）局部区域复发。在32例病理分期为I期的非小细胞肺癌中，10例（31.3%）nm23-H1基因产物呈阳性。在本研究结束时，nm23-H1蛋白水平较高的患者均未检测到远处转移（卡方检验，p<0.05）。目前的中位随访时间仅为35个月（范围为18至83个月），到目前为止，nm23-H1蛋白水平高和低的组之间在总生存率方面未观察到显著差异。
nm23-H1蛋白水平在预测远处转移方面比T分期或组织学类型更有用，据此可选择病例进行术后辅助化疗。
