结合恶性胸腔积液中脱落细胞探讨上皮细胞-间质转化与非小细胞肺癌的相关性

目的探讨恶性胸腔积液(malignant pleural effusion,MPE)中非小细胞肺癌(non-small cell lung cancer,NSCLC)上皮细胞-间质转化(epithelial-mesenchymal transition,EMT)相关分子标志物的表达及意义。方法对823例胸水标本进行液基细胞薄层检测(thinPrep cytology test,TCT),结合活检结果确诊107例NSCLC标本,随机分成NSCLC细胞组、NSCLC活检组及NSCLC癌旁组织组三组,对其中39例NSCLC细胞组胸水标本进行沉渣后包埋、切片,采用免疫组化SP法检测三组中vimentin、E-cadherin、N-cadherin、β-catentin的表达,并进行对比分析。结果E-cadherin、β-catentin阳性/异常阳性率在NSCLC细胞组、活检组均明显低于癌旁组织组(P<0.05)。NSCLC细胞组、活检组N-cadherin、vimentin的阳性率均明显高于癌旁组织组(P<0.05)。同时亦发现,在NSCLC细胞组中,E-cadherin表达与分化程度和淋巴结转移有关(P<0.05),β-catentin异常阳性与分化程度有关(P<0.05),N-cadherin与vimentin表达与淋巴结转移有关(P<0.05)。以上4个抗体表达/异常表达均与患者年龄、性别、吸烟史和组织学分型无关(P>0.05)。结论MPE中NSCLC细胞具备EMT表型,从细胞学角度进一步证实EMT现象存在于NSCLC,为新的靶向治疗药物的研究和治疗靶点提供新思路。

Study on the relationship between epithelial-mesenchymal transition and NSCLC combined with exfoliated cells in malignant pleural effusion

Purpose To investigate the expression and significance of moleculaRmarkers related to epithelial-mesenchymal transition(EMT)in non-small cell lung canceR(NSCLC)cells with malignant pleural effusion.Methods 823 pleural effusion specimens were examined by liquid-based cytology and 107 NSCLC specimens were confirmed by biopsy.They were randomly divided into three groups:NSCLC cell group,NSCLC biopsy group and NSCLC adjacent tissue group.Immunohistochemistry was used to detect the expression of vimentin,E-cadherin,N-cadherin andβ-catentin antibodies in 39 cases of pleural effusion from cell group.Results The positive/abnormal expression rates of E-cadherin,β-catentin in cell group and biopsy group were significantly loweRthan those in para-canceRgroup(P<0.05).The positive expression rates of N-cadherin and vimentin in cell group and biopsy group were significantly higheRthan those in adjacent tissue group(P<0.05).It was also found that in NSCLC cells,the positive expression of E-cadherin was related to the degree of differentiation and lymph node metastasis(P<0.05),the abnormal positive expression ofβ-catentin was related to the degree of differentiation(P<0.05),and the positive expression of N-cadherin and vimentin was related to lymph node metastasis(P<0.05).The positive/abnormal positive expression of the above fouRantibodies was not related to age,sex,smoking status and histological classification of the patients(P>0.05).Conclusion NSCLC cells in malignant pleural effusion have EMT phenotype,which furtheRconfirms the existence of EMT in NSCLC from the cytological point of view,and provides new ideas foRthe research and treatment targets of new targeted drugs.