周围型肺癌CT征象与PCNA和Bcl-2及Caspase-3蛋白表达关联研究  

Correlation between CT signs and expressions of PCNA,Bcl-2 and Caspase-3 in 66 patients with peripheral lung cancer

作　　者：杨丽[1] 张祖艳 柴大敏[3] YANG Li;ZHANG Zu-yan;CHAI Da-min(First Affiliated Hospital of Bengbu Medicial College,Bengbu 233000,P.R.China;Department of imaging,Xuzhou First People's Hospital,Xuzhou 221002,P.R.China)

机构地区：[1]蚌埠医学院第一附属医院放射科,安徽蚌埠233000 [2]徐州市第一人民医院影像科,江苏徐州221002 [3]蚌埠医学院第一附属医院病理科,安徽蚌埠233000

出　　处：《中华肿瘤防治杂志》2020年第8期605-611,共7页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的增殖细胞核抗原(proliferating cell nuclear antigen,PNCA)也称周期蛋白,其表达水平与DNA合成密切相关,可用作细胞增殖评价,对于恶性肿瘤的严重程度及预后预测均有较大价值。B细胞淋巴瘤/白血病-2蛋白(B cell lymphoma/leukemia-2,Bcl-2)及半胱氨酸蛋白酶-3(Caspase-3)均在细胞凋亡阶段起重要作用,并参与周围型肺癌发生与发展过程的调控。探讨周围型肺癌CT征象与PNCA、Bcl-2及Caspase-3表达间的关联性。方法选择2017-02-12-2018-03-16蚌埠医学院第一附属医院手术治疗的66例周围型肺癌组织及相应的癌旁组织(距癌组织≥5 cm)为研究对象。对患者行常规CT平扫,病灶部位以3~5 mm的层厚进行薄扫。以免疫组织化学SP法检测周围型肺癌组织中PCNA、Bcl-2和Caspase-3表达情况。分析CT征象与PCNA、Bcl-2、Caspase-3表达间关联性。结果66例周围型肺癌组织中PCNA表达PI指数为(38.29±12.04)%,Bcl-2表达PI指数为(38.09±9.35)%,Caspase-3表达PI指数为(42.88±10.09)%。周围型肺癌组织PCNA、Bcl-2及Caspase-3阳性表达率均高于癌旁组织,差异有统计学意义,t值分别为5.400、6.417和11.064,均P<0.05。单因素基础上多因素分析结果显示,肿瘤直径(OR=1.593,95%CI:1.204~2.358)、深分叶征(OR=1.533,95%CI:1.164~2.093)、纵隔淋巴结转移(OR=1.612,95%CI:1.188~2.117)、癌性空洞(OR=1.972,95%CI:1.283~2.841)为PCNA表达的独立影响因素,毛刺征(OR=1.612,95%CI:1.188~2.117)、胸膜凹陷征(OR=1.539,95%CI:1.164~2.093)为Bcl-2表达的独立影响因素,肿瘤直径(OR=0.283,95%CI:0.073~1.094)及纵隔淋巴结转移(OR=7.876,95%CI:1.818~34.109)为Caspase-3表达的独立影响因素。结论周围型肺癌患者PCNA、Bcl-2和Caspase-3均表达上调,患者肿瘤直径、深分叶征、纵隔淋巴结转移的PCNA、Bcl-2、Caspase-3表达差异均有统计学意义,可用于判断肿瘤的恶性生物学行为。OBJECTIVE To investigate the relationship between CT features of peripheral lung cancer and the expression of PCNA,Bcl-2 and Caspase-3.METHODS A total of 66 patients with peripheral lung cancer who were treated at the First Affiliated Hospital of Bu Medical College from February 12,2017 to March 16,2018 were selected for the study.The patient underwent routine CT scan,and the lesion was thinly scanned with a layer thickness of 3 to 5 mm.The expression of PCNA,Bcl-2 and Caspase-3 in peripheral lung cancer tissues was detected by immunohistochemical SP method.The relationship between CT signs and PCNA,Bcl-2 and Caspase-3 expression was analyzed.RESULTS The PI of PCNA expression was(38.29±12.04)%,Bcl-2 expression was(38.09±9.35)%,Caspase-3 expression was(42.88±10.09)%.The positive expression rates of PCNA,Bcl-2 and Caspase-3 in peripheral lung cancer tissues were higher than those in adjacent tissues,and the difference was statistically significant(t=5.400,6.417,11.064,all P<0.05).The results of multivariate analysis on a single factor basis showed:tumor diameter(OR=1.593,95%CI:1.204-2.358),deep lobe sign(OR=1.533,95%CI:1.164-2.093),mediastinal lymph node metastasis(OR=1.612,95%CI:1.188-2.117),cancerous cavity(OR=1.972,95%CI:1.283-2.841)are independent factors affecting the expression of PCNA,glitch sign(OR=1.612,95%CI:1.188-2.117),pleural depression sign(OR=1.539,95%CI:1.164-2.093)are independent influencing factors of Bcl-2 expression,tumor diameter(OR=0.283,95%CI:0.073-1.094)and mediastinal lymph node metastasis(OR=7.876,95%CI:1.818-34.109)are independent factors affecting the expression of Caspase-3.CONCLUSIONS PCNA,Bcl-2 and Caspase-3 are highly expressed in peripheral lung cancer patients.The expressions of different PCNA,Bcl-2 and Caspase-3 in tumor diameter,deep lobulation and mediastinal lymph node metastasis are significantly different.

关 键 词：周围型肺癌 CT征象 增殖细胞核抗原 BCL-2 Caspase-3 

分 类 号：R734.2[医药卫生—肿瘤]