摘要目的 探讨肝细胞膜表面相关抗原(HAb18G)表达与非小细胞肺癌的侵袭、转移及预后的关系.方法 用免疫组织化学SP法检测144例非小细胞肺癌组织、19例肺良性病变和41例正常肺组织中HAb18G蛋白的表达,用图像分析软件对HAb18G蛋白表达的阳性单位(PU)进行定量测试.结果 HAb18G在非小细胞肺癌组织中的表达主要定位于肺癌细胞膜或胞质,其在肺良性病变及正常肺组织中几乎不表达.在非小细胞肺癌患者中,25例低表达(17.4％),119例高表达(82.6％)；59例膜表达为主(41.0％),81例胞质表达为主(56.3％),4例无阳性着色(2.8％).HAb18G蛋白表达的PU值在非小细胞肺癌组织中显著高于非肺癌肺组织(P=0.000)；高分化肺鳞癌和腺癌低于中至低分化肺鳞癌和腺癌(P=0.001)；HAb18G蛋白在TNM Ⅰ期、Ⅱ～Ⅲ期、Ⅳ期中依次升高(P=0.000),非小细胞肺癌伴淋巴结转移的原发灶高于无转移的原发灶(P =0.045)；蛋白PU值在最大直径＞5 cm的非小细胞肺癌组织中的表达大于最大直径≤5 cm的肺癌组织(P=0.000),男性患者高于女性患者(P=0.046),与非小细胞肺癌患者年龄、吸烟史、大体类型及原发灶和相应转移灶的情况均无关(P＞0.05).HAb18G低表达患者的5年生存率大于HAb18G高表达患者(P=0.006)；单因素分析结果表明HAb18G高表达的非小细胞肺癌患者预后差(P=0.007)；Cox分析结果显示HAb18G表达是非小细胞肺癌患者的独立预后因素(P=0.032,相对危险度为3.962).结论 HAb18G蛋白在肺癌组织中的表达与非小细胞肺癌的发生发展、浸润转移和预后密切相关,可作为预测浸润转移和估计预后的一个参考指标.

abstractsObjective To study the association between HAb18G expression,tumor parameters,metastatic potential and prognosis in non-small cell lung carcinoma ( NSCLC ). Methods Immunohistochemical study for HAb18G protein using SP methods was carried out in 144 cases of NSCLC.Nineteen cases of benign lung lesions and 41 cases of normal lung tissue were used as controls.The intensity (positive unit/PU) of HAb18G expression was assessed quantitatively by image analysis software.The results were correlated with tumor parameters,metastatic potential and follow-up data. Results The intensity of HAb18G protein expression was significantly higher in NSCLC than that in controls (P=0.000).In squamous cell carcinomas and adenocarcinomas,the expression of HAb18G protein in well-differentiated tumors was lower than that in moderately to poorly differentiated tumors ( P =0.001 ).Tumors of TNM stage IV had stronger expression than tumors of lower stages ( P =0.000).HAb18G PU was greater in tumors with lymph node metastasis than those without nodal metastasis ( P =0.045 ).The PU value of tumors with maximal diameter greater than 5 cm was higher than that of the smaller tumors (P =0.000).It was also higher in male than in female patients ( P =0.046 ).There was no association between HAb18G protein expression and age of patients,history of smoking,tumor types and gross morphology (P ＞ 0.05 ).The five-year survival rate in cases with low HAb1 8G protein expression was higher than that in cases with high expression ( P =0.006).Univariate analysis indicated that patients with high HAb18G protein expression carried a poor prognosis ( P =0.007 ). Multivariate analysis showed that expression of HAb18G protein was an independent prognostic factor in patients with NSCLC ( P =0.032,relative risk 3.962).Conclusions HAb18G protein expression is associated with tumor progression and prognosis.It may represent a useful biomarker for prognostic evaluation.