E-钙黏蛋白和波形蛋白表达与非小细胞肺癌铂类药物疗效相关性研究

目的 探索上皮间质化因子E-cadherin和Vimentin表达与非小细胞肺癌铂类药物疗效相关性。方法 回顾性收集2008年1月~2012年12月我院诊断为非小细胞肺癌、采用含铂方案治疗的患者资料及病理组织标本,以免疫组织化学染色法检测E-cadherin和Vimentin表达,评价E-cadherin和Vimentin表达与NSCLC临床特征的相关性,并以Kaplan-Meier生存曲线和COX回归风险比例模型评价E-cadherin和Vimentin表达与NSCLC含铂方案治疗效果的相关性。结果 共99例NSCLC患者纳入研究,肿瘤组织中E-cadherin和Vimentin表达存显著负相关(P＜0.001,r=-0.410)。中晚期、低分化、有淋巴结转移的肺癌组织E-cadherin的阳性率降低,Vimentin阳性率增高。E-cadherin表达阳性患者OS显著高于阴性患者(中位OS 31 vs.21 months,HR 0.533,95%CI：0.322~0.882,P = 0.014),Vimentin与OS无相关性。E-cadherin和Vimentin表达与疾病进展时间无显著相关性(P＞0.05)。结论 E-cadherin是一个有潜力的NSCLC铂类药物疗效的预测因子,这仍需进一步前瞻性研究验证。

Correlation of E-cadherin and Vimentin Expression with Prognosis of Non-small-cell Lung Cancer and Sensitivity to Platinum-based Chemotherapy

OBJECTIVE To investigate the correlations among E-cadherin and vimentin expression, epithelialmesenchymal transition factors, prognosis for non-small-cell lung cancer (NSCLC), and the sensitivity to platinum-based chemotherapy. METHODS Medical record data and pathological tissue specimens of NSCLC patients treated by platinum-based chemotherapy from January 2008 to December 2012 were collected retrospectively. Immunohistochemistry was performed to detect E-cadherin and vimentin expression and evaluate their correlation with clinical characteristics. Kaplan-Meier survival curve and Cox proportional hazards regression model were used to evaluate the correlation of E-cadherin and vimentin expression with prognosis of NSCLC and sensitivity to platinum-based chemotherapy. RESULTS A total of 99 NSCLC patients were enrolled in this study. A significant negative correlation was found between E-cadherin and vimentin expression in tumor tissues (P<0.001, r=-0.410). For lung cancer tissues with less differentiation and lymph node metastasis in middle and late stages, the positive rate of E-cadherin decreased, whereas the positive rate of vimentin increased. The OS of patients showing positive expression of E-cadherin was significantly higher than that of patients showing negative expression of E-cahedrin (median OS 31 vs 21 months, HR 0.533, 95%CI:0.322-0.882, P=0.014). However, vimentin was not correlated with OS. Moreover, E-cadherin and vimentin expression was not significantly correlated with disease progression(P>0.05). CONCLUSION E-cadherin can be used as a potential NSCLC prognostic factor but not as a predictive factor for the sensitivity of NSCLC platinum-based chemotherapy. Overall, the results need further investigation.