Cyclin A、CDK2基因在非小细胞肺癌中的表达及其意义

目的研究细胞周期素A（Cyclin A）和细胞周期素依赖性激酶2（cyclin—dependent kinases，CDK2）基因在非小细胞肺癌（non—small—cell lung cancer，NSCLC）组织中的表达及其相互关系，探讨其对NSCLC发生、发展、淋巴结转移及预后的影响。方法采用免疫组织化学二步法检测40例NSCLC（伴淋巴结转移21例，不伴淋巴结转移19例），11例支气管黏膜上皮增生或不典型增生，9例淋巴结转移癌组织中Cyclin A、CDK2蛋白的表达，并随访40例NSCLC患者3年生存期。结果在支气管黏膜上皮增生或不典型增生，不伴淋巴结转移的NSCLC，伴淋巴结转移的NSCLC，淋巴结转移癌组织中，Cyclin A蛋白的阳性表达率分别为9．09％（1／11），31．58％（6／19），80．95％（17／21），66．67％（6／9）；CDK2蛋白的阳性表达率分别为9．09％（1／11），36．84％（7／19），76．19％（16／21），77．7896（7／9）；不伴淋巴结转移的NSCLC组织中的Cyclin A、CDK2蛋白阳性表达率分别与伴淋巴结转移NSCLC组织、淋巴结转移癌组织的Cyclin A、CDK2蛋白阳性表达率比较，差异均有显著性（P均〈0．05）。23例Cyclin A蛋白表达阳性患者3年生存率为21．74％（5／23），17例表达阴性患者3年生存率为58．82％（10／17），两者比较有显著性差异（P〈0．05）；23例CDK2蛋白表达阳性息者3年生存率为17．39％（4／23），17例表达阴性患者3年生存率为64．71％（11／17），两者比较有显著性差异（P〈0．05）。NSCLC中Cyclin A与CDK2蛋白表达呈正相关（x^2=19．22，P〈0．001，列联系数Pearson=0．570）。结论在NSCLC发生、演进、浸润、淋巴结转移过程中Cyclin A、CDK2起正调控作用，NSCLC组织中Cyclin A、CDK2表达上调可作为判断NSCLC预后不良的参考指标。

Significance of Cyclin A、CDK2 Expression in Non-Small-Cell Lung Cancer

Objective To investigate the expression and their mutual relation of the CyclinACDK2 gene in human non-small-cell lung cancer(NSCLC),and to study their role in the carcinogenesisdevelopmentlymphy nodes metastases and prognosis of NSCLC.Methods The expression of cyclin A and CDK2 was tested by immunohistochemical method(two steps method) in 40 cases of NSCLC(21 cases with lymphy nodes metastases),11 cases of bronchial epithelium dysplasia and 9 specimens of lymph nodes metastases.The 3-years survival rate was observed in the follow-up period of 40 cases of NSCLC.Results In bronchial epithelium dysplasia,NSCLC without and with lymphy nodes metastases,and specimens of lymphy nodes metastases,the positive rate of Cyclin A protein was 9.09%(1/11),31.58%(6/19),80.95%(17/21) and 66.67%(6/9)respectively,the positive rate of CDK2 protein was 9.09%(1/11),36.84%(7/19),76.19%(16/21) and 77.78%(7/9) respectively.The expression of Cyclin A and CDK2 was significantly different between NSCLC with or without lymphy nodes metastases(P<0.05).The 3-year survival rate was 21.74%(5/23) for positive Cyclin A patients and 58.82%(10/17) for negative Cyclin A patients,showing a significant difference(P<0.05).The 3-year survival rate was 17.39%(4/23) for positive CDK2 patients and 64.71%(11/17) for negative CDK2 patients,showing a significant difference(P<0.05).Cyclin A expression positively correlated with CDK2 expression(~2=19.22,P<0.001,Pearson=(0.570)).Conclusion Cyclin A and CDK2 might play an important role in the carcinogenesis,development,and lymphy nodes metastases of NSCLC.Up-regulation of Cyclin A and CDK2 expression indicates a poor prognosis for patients with NSCLC.