Claudin-18蛋白在肺腺癌所致恶性胸腔积液中的表达及临床意义  

Expression of Claudin-18 and its clinical significance in malignant pleural effusion associated with lung adenocarcinoma

作　　者：刘英杰[1] 桂淑玉[1] 周青[2] 汪渊[2] 

机构地区：[1]安徽医科大学第一附属医院呼吸内科,合肥230022 [2]安徽医科大学分子生物学实验室,合肥230032

出　　处：《安徽医科大学学报》2014年第12期1788-1792,共5页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金(编号:81272399)

摘　　要：目的探讨Claudin-18蛋白在肺腺癌所致恶性胸腔积液中的表达及其临床意义。方法选取50例肺腺癌所致恶性胸腔积液和37例肺部良性疾病所致胸腔积液标本,使用免疫组化和Western blot法检测Claudin-18蛋白表达,并与胸液细胞学结果比较,分析Claudin-18蛋白表达与临床特征、疗效间关系。结果 Claudin-18蛋白诊断肺腺癌所致恶性胸腔积液的敏感性38%,特异性100%,总准确率64.4%。与胸液细胞学(敏感性54%)比较,差异无统计学意义,两者联合检测敏感性增至68%。Claudin-18在非吸烟肺腺癌患者中阳性率为50.0%,而在吸烟肺腺癌患者中阳性率仅为12.5%,两者比较差异有统计学意义(P=0.011),Claudin-18在恶性胸腔积液中表达与患者年龄、性别、肿瘤大小、淋巴结转移、远处转移及疗效无关。结论 Claudin-18可能参与肺癌发生、发展过程,尤其非吸烟肺癌患者;胸腔积液Claudin-18与细胞学联合检测可提高恶性胸腔积液诊断的阳性率,并具有一定的鉴别诊断价值。Objective To investigate the expression of Claudin-18 protein in malignant pleural effusions associated with lung adenocarcinoma and its clinical significance.Methods 50 malignant pleural effusions associated with lung adenocarcinoma and 37 benign pleural effusions were collected.Specimens were analyzed for the expression of claudin-18 using immunocytochemistry and Western blot.Futhermore,claudin-18 expression was compared with exfoliated cytology.The significance of claudin-18 expression in malignant effusion and its association with clinicopathological feathers and therapeutic effect were also analyzed.Results With the immunocytochemistry method,the sensitivity,specificity,accuracy were 38％,100％,64.4％,respectively.There was no statistically significant difference when claudin-18 expression was compared with exfoliated cytology （38％ vs 54％）.However,with the combination of both methods to detect malignant pleural effusion,the sensitivity increased to 68％.The expression rate of claudin-18 protein was 50.0％ in lung adenocarcinoma of nonsmokers,significantly higher than that in lung adenocarcinoma of smokers （12.5％,P =0.011）,while no association was found between claudin-18 and sex,age,tumor size,nodal metastases,distant metastases or therapeutic effect.Conclusion Claudin-18 protein may be involved in the carcinogenesis of lung adenocarcinoma,especially in nonsmokers.The combining examination of claudin-18 expression and exfoliated cytology can enhance the positive diagnostic rate of malignant pleural effusion and has differential diagnosis value.

关 键 词：肺腺癌 恶性胸腔积液 Claudin-18 免疫组织化学 

分 类 号：R734.2[医药卫生—肿瘤] R561.3[医药卫生—临床医学]