肺癌多种基因同步检测及临床相关性(诊断及预后)的研究

目的 :为检测非小细胞肺癌中多种基因的改变 ,并探讨其临床相关性 (诊断及预后 )。方法 :本研究用LSAB(labelledstreptavidinbiotin)法同步检测 10 4例非小细胞肺癌 (NSCLC)组织中抗癌基因p16,pRb及癌基因cy clinD1,cdk4和转移相关基因nm 2 3 H1,CD4 4v6表达。结果 :3 2 8%的鳞癌和 5 3 7%的腺癌不表达p16蛋白 ,腺癌明显高于鳞癌 (P <0 0 5 ) ;腺癌只有 14 6%完全不表达pRb蛋白 ,鳞癌不表达率为 3 6 2 % (P <0 0 5 ) ;5 7 7%的肿瘤只表达p16或pRb中的一项 ;3 2 7%的肿瘤两者都表达 ,但两者表达强度差异明显 ,9 6%的肿瘤两者均表达且表达强度一致 ;88 6%的肿瘤表达cdk4,在高分化鳞癌中表达率为 66 7% ,中分化鳞癌 96 3 % ,低分化鳞癌达10 0 % ,大约 70 %的肺癌中有cyclinD1表达 ,而正常粘膜中只有 2 0 %有表达 (P <0 0 0 0 1) ,表明非小细胞肺癌中cy clinD1的表达明显增高。在无淋巴结转移组 ,其nm 2 3的表达率高达 78 8% ,与有淋巴结转移组的表达率 2 1 9%相比 ,有非常显著性差异 (P <0 0 0 0 1) ;有淋巴结转移组 ,CD4 4v6的表达率高达 96 9% ,与无淋巴结转移的表达率相比 ,差异具非常显著性 (P <0 0 0 0 1)。结论 :①p16及pRb基因的表达在肺癌中明显减弱 ,均与非小细胞肺癌的组织学类型有关

A study on kinds of genes expression in non small cell lung cancers and its clinical relationship

Objective: To observe the expression of kinds of genes in non small cell lung cancers and its clinical relationship.Methods: The LSAB method was used to inspect the expression of p16,pRb,cdk4,cyclin D1,nm23 H1 and CD 44 v 6 in 104 cases of resected lung cancers.Results: 67% of squamous cell cascinomas and 46% of adenocarcinomas expressed p16,64% of squamous cell carcinomas and 85% of adenocarcinomas expressed pRb and 66% of cancers expressed incresed trend with decreasing differentiation of both squamous cell carcinomas and adenomas expressed cdk4.Only 21.9% of the tumors with metastasis in hilum lymph nodes expressed nm23 H1 but the expression rat of the tumors without metastasis was 78.8%( P <0.0001).96.9% of tumors with metastases in hilum lymph nodes expressed CD 44 v 6 and only 28.8% of the tumors with no metastasis expressed CD 44 v 6.Conclusion: The aberrant p16 and pRb geneproduct expression played a significant role in the development and histological subtype of lung cancers by conditioning the biologcial behavior of NSCLC.cdk4 was an important factor in histological differentiation.Both CD 44 v 6 and nm23 H1 can be condidered as markers to indicate the metastatic potential in nonsmall cell lung cancers.