非小细胞肺癌中CD133和Notch1的表达及其临床病理意义

摘要

目的：通过检测非小细胞肺癌（NSCLC）中CD133蛋白和Notch1蛋白的表达及相互之间的关系，研究它们与NSCLC患者临床病理因素之间的关系。方法采用免疫组织化学ElivisionTM plus法检测305例NSCLC组织和80例正常肺组织中CD133、Notch1以及血管内皮生长因子（VEGF）蛋白表达情况。结果在NSCLC组和正常肺组织中CD133、Notch1和VEGF蛋白的阳性表达率分别为48.9%、43.9%、45.6%和10.0%、15.0%、0%，两组之间相比差异有统计学意义；CD133、Notch1和VEGF蛋白的阳性表达率在NSCLC患者肿瘤组织的不同分化程度、淋巴结转移与否及临床分期间差异有统计学意义（P<0.05）；且CD133、Notch1和VEGF三种蛋白之间相互呈正相关关系（P<0.001）。Kaplan-Meier生存分析显示，CD133、Notch1和VEGF蛋白阳性表达组患者的生存时间明显短于其阴性表达组患者，差异有统计学意义；Cox多因素回归分析显示，CD133和Notch1蛋白的表达是影响NSCLC患者预后的独立因素（P<0.05）。结论 CD133、Notch1和VEGF参与NSCLC的发生、发展、浸润和转移，联合检测CD133和Notch1蛋白的表达对NSCLC的进展和预后判断有重要意义。%Objective To investigate the presence of cancer stem cells (CSCs) exist in non-small cell lung cancer (NSCLC) and explore the relationship among the expressions of CD133, Notch1, and vascular endothelial growth factor (VEGF) and their relations with the clinicopathological parameters of the patients. Methods A total of 305 specimens of NSCLC and 80 normal lung tissue specimens were analyzed for CD133, Notch1, and VEGF protein expressions by immunohistochemical staining. Results In NSCLC specimens, the positivity rates of CD133, Notch1, and VEGF were 48.9%, 43.9%, and 45.6%, respectively, significantly higher than those in normal lung tissues (10.0%, 15.0%, and 0%, respectively, P<0.01). The expression levels of CD133, Notch1, and VEGF proteins were significantly correlated with the tumor grades, lymph node metastasis, TNM stages, and postoperative survival time of the patients (P<0.01). A positive correlation was found among the expression levels of CD133, Notch1, and VEGF proteins. Kaplan-Meier survival analysis showed a significantly lower overall mean survival time of the patients positive for CD133, Notch1, and VEGF than that of the negative patients (P<0.001). Cox regression analysis suggested that positive expressions of CD133 and Notch1 were independent prognostic factors of NSCLC (P<0.05). Conclusions CD133, Notch1, and VEGF may play important roles in the occurrence, progression, invasion, and metastasis of NSCLC. CD133 and Notch1 have important values for predicting the prognosis and evaluating disease progression of the patients.