上皮-间叶转变相关蛋白在非小细胞肺癌中的表达及其预后意义

摘要

Background and purpose: Metastasis is the most common cause of disease failure and mortality for non-small cell lung cancer (NSCLC) after surgical treatment. Epithelial-mesenchymal transition (EMT)is known to be involved in the progression and metastasis of various cancers. The aim of this study was to evaluate the prognostic value of the expression of EMT-related proteins Snail, Vimentin, E-cadherin and β-catenin in patients with NSCLC. Methods: The tissue microarray (TMA) technique and immunohistochemistry stain were used to detect the expression of the Snail, Vimentin, E-cadherin and β-catenin proteins in 165 NSCLC tissues. The relationship between the expression of Snail, Vimentin, E-cadherin and β-catenin and the patients' overall and prognostic was investigated.Results: An over-expression of Snail, Vimentin, E-cadherin or β-catenin was shown in 45.5％, 33.9％, 66.7％ and 50.9％ of primary tumors, respectively. The expression of E-cadherin in 165 NSCLC cases was associated with the Snail (P＜0.001) and the β-catenin (P=0.003). Over-expression of the Snail, Vimentin, E-cadherin/β-catenin complex were associated with a shorter overall survival (P=0.0059, P=0.0257, P=0.0025). Co-expression of more than two markers is an independent prognostic indicator for overall survival (P＜0.001). Conclusion: Co-expression of more than 2 markers from proteins Snail, Vimentin, E-cadherin/β-catenin complex is a significant prognostic predictor for patients with NSCLC.%背景与目的:非小细胞肺癌(non-small cell lung cancer,NSCLC)患者最主要的死亡原因是手术后肿瘤转移,而上皮-间叶转变(epithelial-mesenchymal transitions,EMT)是肿瘤发生侵袭、转移的重要原因.本研究探讨EMT相关蛋白Snail、Vimentin、E-cadherin和B-catenin在NSCLC患者中的表达及其预后意义.方法:采用组织芯片技术和免疫组织化学EnvVision两步法检测Snail、Vimentin、E-cadherin和β-catenin蛋白在165例NSCLC患者中的表达情况.根据免疫组织化学结果对NSCLC患者分组,分析Snail、Vimentin、E-cadherin和β-catenin蛋白在判断患者预后和生存情况中的作用.结果:165例NSCLC患者中,Snail、Vimentin、E-cadherin和β-catenin的阳性表达率分别为45.5%、33.9%、66.7%和50.9%.E-cadherin 的表达与Snail呈负相关(P＜0.001),而与β-catenin的表达呈正相关(P=0.003).Snail、Vimentin、E-cadherin/β-catenin复合体异常表达组的生存期均显著低于正常组(P=0.005 9,P=0.025 7,P=0.002 5).上述任意两个蛋白的异常表达是一个独立的预后因素(P＜0.001).结论:EMT相关蛋白Snail、Vimentin和E-cadherin/β-catenin复合体三者中的任意2种蛋白异常表达可作为判断患者预后的独立指标.