肺腺癌中Napsin A、SP-A蛋白的表达和EGFR基因突变及临床相关性  

Napsin A,SP-A protein expression and EGFR gene mutation and clinical relevance in lung adenocarcinoma

作　　者：王学文 郝佳洁 周菲 孙晓男 常晨 蔡岩 徐昕 王明荣 贾雪梅[1] Wang Xuewen;Hao Jiajie;Zhou Fei(Dept of Histology ＆ Embryology,Anhui Medical University,Hefei 230032;State Key Laboratory of Molecular Oncology,National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021)

机构地区：[1]安徽医科大学组织胚胎学教研室,合肥230032 [2]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院,分子肿瘤学国家重点实验室,北京100021

出　　处：《安徽医科大学学报》2018年第8期1260-1265,共6页Acta Universitatis Medicinalis Anhui

基　　金：中国医学科学院医学与健康科技创新工程重大协同创新项目(编号:2016-I2M-1-001);国家科技支撑计划课题(编号:2014BAI09B01)

摘　　要：目的探讨肺腺癌组织中Napsin A蛋白和SP-A蛋白的表达及EGFR基因突变情况,并分析三者的相关性及临床意义。方法应用组织微阵列-免疫组织化学染色技术检测216例肺腺癌组织中Napsin A蛋白和SP-A蛋白的表达情况。应用聚合酶链式反应(PCR)产物Sanger测序法,检测45例肺腺癌中EGFR基因的突变情况,并进一步分析其与临床病理特征及预后的相关性。结果 Napsin A和SP-A蛋白在肺腺癌中阳性率分别为74.5%(161/216)和34.3%(74/216)。EGFR基因突变率为31.1%(14/45),EGFR基因突变率在Napsin A蛋白阳性者高于其阴性者(P=0.020)。Kaplan-Meier生存分析表明Napsin A蛋白阳性患者的总生存期长于阴性患者(P=0.003)。Cox回归分析显示Napsin A蛋白表达水平为独立的预后因素(P=0.002,HR=0.356,95%CI:0.188~0.674)。结论 Napsin A蛋白阳性表达有助于肺腺癌的诊断且是独立的预后因素。Napsin A蛋白表达阳性的肺腺癌组织中EGFR基因突变率较高。Objective To observe Napsin A,SP-A protein expressions,EGFR gene mutations and their clinical relevance in lung adenocarcinoma tissues. Methods Immunohistochemical staining method was used to detect Napsin A and SP-A protein expressions in 216 cases of lung adenocarcinoma tissues. EGFR mutations were examined in 45 lung adenocarcinoma tissues by PCR and DNA sequencing. Results The positive rates of Napsin A protein and SP-A protein in lung adenocarcinomas were 74. 5%（161/216） and 34. 3%（74/216）,respectively. EGFR gene mutation rate was 31. 1%（14/45） in lung adenocarcinomas. Patients with positive Napsin A expression had higher EGFR gene mutation rate than those with negative expression（ P = 0. 020）. Kaplan-Meier curves showed that the overall survival（ OS） of patients with positive Napsin A was longer than that of the negative patients（ P = 0. 003）. Cox regression analysis showed that the positive expression of Napsin A protein was an independent prognostic factor（ P = 0. 002,HR = 0. 356,95% CI：0. 188 ~ 0. 674）. Conclusion Positive Napsin A expression in lung adenocarcinoma tissues is useful diagnostic and favorable prognostic indicator. EGFR gene mutation is frequently detected in lung adenocarcinoma tissues with positive Napsin A protein.

关 键 词：肺腺癌 免疫组织化学 突变 SP-A NAPSIN A EGFR 

分 类 号：R734.2[医药卫生—肿瘤]