非小细胞肺癌中caspase-3、survivin和k-ras的表达及其意义  

Expression and clinical significance of caspase-3、survivin and k-ras in non-small cell lung cancer

作　　者：李承慧[1] 胡冰[2] 王晓秋[3] 季楚舒[2] 何义富[2] 

机构地区：[1]安徽医科大学附属安庆医院肿瘤科,安庆246000 [2]安徽医科大学附属省立医院肿瘤科,合肥230000 [3]安徽医科大学附属省立医院病理科,合肥230000

出　　处：《中国肺癌杂志》2008年第1期90-96,共7页Chinese Journal of Lung Cancer

摘　　要：背景与目的非小细胞肺癌(non-small cell lung cancer,NSCLC)的预后与众多因素有关,凋亡相关基因在肿瘤的发生发展过程中发挥重要的作用,但其在NSCLC中作为生物预后因素的意义还不明确。本研究的目的是探讨凋亡相关基因caspase-3、survivin、k-ras在NSCLC中的表达与不同临床病理特征和预后的关系,并探讨三者在NSCLC发生过程中可能存在的相关性。方法采用免疫组化SP二步法检测91例石蜡标本癌组织和癌旁正常组织中caspase-3、survivin、k-ras蛋白的阳性表达。结果Caspase-3在癌组织中阳性表达率低于癌旁正常组织,survivin、k-ras在癌组织阳性表达高于癌旁正常组织,均具有统计学差异(P<0.05)。Caspase-3阳性表达与年龄、病理类型、TNM分期、淋巴结状态、分化程度有关(P<0.05),而与病灶大小、有无吸烟史等无关(P>0.05);survivin阳性表达与年龄、TNM分期、分化程度、淋巴结状态有关(P<0.05),而与病理类型、病灶大小、有无吸烟史等无关(P>0.05);k-ras阳性表达与病理类型、吸烟有关(P<0.05),与年龄、TNM分期、淋巴结状态、分化程度、病灶大小等均无关(P>0.05)。Caspase-3与survivin的阳性表达呈负相关(r=-0.662,P<0.001)。Cox多因素分析survivin,caspase-3,TNM分期、病理类型、分化程度5个因素具有独立预后价值(P<0.05)。结论Survivin和k-ras在NSCLC中高表达,而caspase-3在NSCLC中低表达,可能在肿瘤细胞凋亡过程中起着重要的作用;Caspase-3低表达、survivin高表达可作为术后NSCLC预后不良的独立性因素;K-ras与NSCLC预后的关系需要进一步研究。Background and objective The prognosis of non-small cell lung cancer （NSCLC） is related to many factors. Apoptosis-related genes play an important role in occurrence and development of tumors. The significance of apoptosis as a biological and prognostic factor has not been clearly established in NSCLC. The aim of the study is to evaluate the relationship between expression of caspase-3 ,survivin,k-ras protein and the relationship between the expression of above proteins in NSCLC and theirs clinicopathological characteristics and prognostic significance and their potential relevance existing in NSCLC. Methods Caspase-3 ,survivin,k-ras protein expression were detected in NSCLC tissues and normal lung tissues adjacent to carcinomas Archival formalin fixed, paraffin embedded specimens from 91 patients who had undergone radical surgery by streptavidin-peroxidase immunohisto- chemistry. Results The positive rate of caspase-3 was significantly lower in NSCLC than in normal lung tissues adjacent to carcinomas; The positive rate of survivin,k-ras was significantly higher in NSCLC than in normal lung tissues adjacent to carcinomas （P 〈 0.05）. The positive rate of caspase-3 was related to the age,histological type, TNM stage,lymph node metastasia and differentiation （P 〈 0.05）, but not related to tumor size,smoke（P 〉 0.05）; the positive rate of survivin was related to the age,TNM stage,lymph node metastasia and differentiation （P 〈 0.05）, but not related to histologic type,tumor size,smoke（P 〉 0.05）; the positive rate of k-ras was related to the histologic type and smoke（P 〈 0.05）, but not related the age,TNM stage ,lymph node metastasia ,differentiation,tumor size（P 〉 0.05）. Expression of caspase-3 was negatively correlated with survivin （r=-0.662, P 〈 0.001）. The multivariate analysis with Cox hazard model, survivin,caspase-3,histologic type,differentiation,TNM stage could be indicators for the prognosis of patients with NSCLC （P 〈 0.05）. Conclusion There are over-

关 键 词：肺肿瘤 凋亡 免疫组化 预后 

分 类 号：R734.2[医药卫生—肿瘤]