非小细胞肺癌中TAMs、Ki-67的表达及预后意义

摘要

目的 探讨肿瘤相关巨噬细胞(tumor associated macrophages,TAMs)、肿瘤增殖因子(Ki-67)在非小细胞肺癌(non-small cell lung cancer,NSCLC)中的表达及其与临床病理特征的关系,并研究其与预后的关系.方法 采用免疫组织化学SP法检测68例NSCLC组织和17例癌旁正常肺组织中CD68(TAMs表面标志)、Ki-67的表达情况.根据随访结果 ,应用Kaplan-Meier生存分析和Cox回归法分析CD68、Ki-67与肺癌预后的关系.结果CD68、Ki-67在68例肺癌组织中的阳性率分别为66.2%(45/68)、61.8%(42/68),在正常肺组织中的阳性表达率分别为17.6%(3/17)、5.9%(1/17),差异均有统计学意义(P<0.05).CD68、Ki-67在高TNM分期、淋巴结转移、侵及胸膜的NSCLC组织中的表达明显著增高(P<0.05).低分化者Ki-67的表达明显增高(P<0.05).NSCLC中CD68与Ki-67的表达呈正相关(r=0.461,P=0.000).68例NSCLC患者1、3、5年生存率分别为86.76%、64.71%、16.18%.Cox多因素分析显示,分化程度低和淋巴结转移是预后不良的危险因素(P<0.05).结论CD68、Ki-67阳性肺癌患者预后差.CD68、Ki-67在NSCLC的发展、浸润、转移中起一定作用,联合检测可作为临床诊断、辅助治疗的潜在靶点.%Objective To investigate the expression levels of tumor associated macrophages (TAMs),tumor proliferation factor (Ki-67 )in non-small cell lung cancer (NSCLC)and their relationships with the clinical pathological features,and to study its relationship with prognosis. Methods Immunohistochemical SPmethod was used to analyze the expressions of CD68(TAMs surface marker)Ki-67 and in 68 cases of NSCLC tissues and 17 cases of normal lung tissues. According to the results of follow-up,Kaplan-Meier survival analysis and Cox regression analysis of CD68,Ki-67 was used to study its relationship with lung cancer prognosis.Results The positive rates of CD68 and Ki-67 in 68 cases of lung cancer were 66.2%(45/68)and 61.8%(42/68).The positive expression rates of CD68 and Ki-67 in normal lung tissues were 17.6%(3/17), 5.9%(1/17),the difference was statistically significant(P<0.05).The expression of CD68 and Ki-67 in NSCLC tissues with high TNM stage, lymph node metastasis and invasion were significantly increased (P< 0.05 ).In addition,the expression of Ki-67 in poorly differentiated patients increased.There was a positive correlation between CD68 and Ki-67 expression in NSCLC(r =0.461,P=0.000).Sixty-eight patients with NSCLC 1,3,5-year survival rate were 86.76%,64.71%,16.18%.Cox multivariate analysis showed that the low degree of differentiation and lymph node metastasis are risky factors for adverse prognosis(P<0.05).Conclusion CD68,Ki-67-positive lung cancer patients with poor prognosis.CD68 and Ki-67 play a role in the development,invasion and metastasis of NSCLC,and combined detection of them provide a potential target for clinical diagnosis,adjuvant therapy of NSCLC.