YKL-40与肿瘤相关巨噬细胞在非小细胞肺癌中的表达及预后分析

目的：了解非小细胞肺癌（NSCLC）组织中YKL-40蛋白、肿瘤相关巨噬细胞（TAM）表达的变化特征及其与患者预后的关系。方法：95例非小细胞肺癌（NSCLC）患者手术切除标本采用免疫组织化学（ABC）法,检测YKL-40蛋白、TAM的表达。结合术后5年随访资料采用SPSS 13.0进行统计分析。结果：YKL-40蛋白、TAM阳性表达率分别为72.63%和77.89%。YKL-40和TAM高表达患者生存期明显小于低表达者（P〈0.05）;其阳性表达率在临床TNM分期早期组（Ⅰ,Ⅱ期）与晚期组（Ⅲa,Ⅲb期）比较差异有统计学意义（P〈0.05）。多因素Cox模型逐步回归分析结果显示病理分期、手术方式、YKL-40阳性表达、TAM阳性表达以及术后是否规范放化疗5种因素对患者生存期的影响最大。结论：YKL-40和TAM高表达是影响非小细胞癌患者的不良预后因素。

The expression of YKL-40 and tumor-associated-macrophage in non-small cell lung cancer and its relationship with prognosis

Objective： To detect the expression of YKL-40 and Tumor-associated-Macrophage（TAM） in non-small cell lung cancer（NSCLC）and their relationship with clinicopathologic features,as well,to determine the relationship of prognosis.Methods： 95 cases of NSCLC were collected from Huaihe Hospital of Henan University,and all patients were followed up more than 5 years after surgery.Immunohistochemical staining（ABC） was applied to detect the expression characteristic of YKL-40 and TAM.The data were analyzed by SPSS 13.0.Results： YKL-40 and TAM were detected with 72.63% and 77.89%,respectively.Patients with positive expression of YKL-40 and TAM obviously survived less than those with negative expression,and the difference was significant（P0.05）.The positive expression of YKL-40 and TAM in clinical early stage（TNM staging Ⅰ,Ⅱ） and clinical late stage（TNM staging Ⅲa,Ⅲb） showed significant difference（P0.05） respectively.It was shown by stepwise multivariate cox-model analysis that differentiatio,high expression of YKL-40 and TAM,pathological stage,mode of surgery,and postoperative chemical therapy were the most important factors affecting the prognosis of NSCLC（P0.05）.Conclusion： The high expression of YKL-40 and TAM may be independent prognostic indicators for poor prognosis of NSCLC.