表皮生长因子受体survivn和异质性胞核核糖核蛋白A2/B1在肺癌纤维支气管镜刷片细胞学诊断中的价值

摘要

目的 探讨表皮生长因子受体(EGFR)、survivn和异质性胞核核糖蛋白A2和B1(hnRNPA2/B1)在肺癌纤维支气管镜刷片细胞学诊断中的价值.方法 收集纤维支气管镜刷片细胞学临床诊断剩余标本197例,免疫细胞化学两步法(Envision)染色,检测EGFR、survivn和hnRNPA2/B1在非小细胞肺癌(NSCLC)、小细胞肺癌(SCLC)及非肺癌组织中的表达情况.结果 EGFR、survivn和hnRNPA2/B1在NSCLC中表达率分别为81.1%、66.2%和90.9%,在非肺癌组织中的表达率分别为30.3%、3.3%和66.7%,差异均有统计学意义(均P＜0.05);hnRNPA2/B1在SCLC表达率为92.3%,与非肺癌组织比较,差异有统计学意义(P＜0.05).EGFR的表达与肿瘤分化程度、淋巴结转移和TNM分期有关(P＜0.05),hnRNP A2/B1表达与TNM分期有关(P＜0.05).NSCLC和非肺癌组织中,EGFR和survivn共同表达的差异有统计学意义(98.0%和2.0%,P=0.000),EGFR和survivn均不表达的差异亦有统计学意义(38.2%和61.8%,P=0.000).结论 EGFR、survin和hnRNPA2/B1在肺癌纤维支气管镜刷片细胞学诊断中有较高的敏感性和特异性.EGFR与survivn联合应用可以提高细胞学诊断的准确性.EGFR阳性表达与肺癌患者的预后有关.%Objective To study the expression of EGFR, survivn and hnRNPA2/B1 proteins in ThinPrep bronchial brushing cytology specimens and their significance in diagnosis of lung cancer. Methods The protein expression of EGFR, survivn and hnRNPA2/B1 was detected by immunocytochemistry (ICC) in the specimens from 110 cases of non-small cell lung cancer ( NSCLC), 32 cases of small cell lung cancer (SCLC) and 37 cases of non-neoplastic lung lesions. The relationship between EGFR, survivn and hnRNPA2/B1 protein expression and clinical characteristics of the patients was analyzed using SPSS 16.0 software. Results (1) Positive expression was observed in 81.1% of NSCLC for EGFR, 66.2% for survivn, 90.9% for hnRNPA2/B1, significantly higher in NSCLC than in the control specimens (P =0. 000, P = 0. 000, P = 0. 010). The positive expression rate of hnRNPA2/B1 in SCLC was 92.3%,significantly higher than that in the control specimens ( P = 0. 021 ). (2) The expression of EGFR was associated with differentiation ( P = 0.003 ), clinical stage ( P = 0.023 ) and lymph node metastasis ( P =0.038), but was not associated with gender, age and histological types. The survivn expression was not related with the above mentioned clinicopathological features ( P ＞ 0.05 ). Expression of hnRNPA2/B1 was associated with clinical stage (P = 0.017), but not associated with gender, age, histological type,differentiation and lymph node metastasis. (3) There was a significant difference between the co-expression of EGFR and survivn in NSCLC (98.0%) and benign conditions (2.0%, P = 0.000), also a significant difference between the negative expression of both EGFR and survivn in NSCLC ( 38. 2% ) and nonneoplastic lesions (61.8%, P = 0. 000). Conclusions Analysis of EGFR, survivn and hnRNPA2/B1 expression may be an useful adjunct method to stratify controversial cases. The positive expression of EGFR might be associated with invasion, progression and poor prognosis of NSCLC.