摘要目的 探讨窖蛋白-1在肺腺癌中表达的临床病理意义和预后价值.方法 采用免疫组织化学EnVision法检测185例肺腺癌中窖蛋白-1、甲状腺转录因子1(TTF-1)的表达,分析窖蛋白-1表达水平与临床病理参数和预后的关系.结果 窖蛋白-1在肺腺癌中阳性率为26.5％ (49/185),显著低于正常肺组织(阳性率100％,P＜0.01).窖蛋白-1表达水平在男性(P=0.004)、吸烟(P=0.006)、肿瘤最大径＞3.5 cm(P =0.048)、实体为主型腺癌(P =0.025)、高危险度(P =0.044)、脉管侵犯(P=0.019)、淋巴结转移(P =0.030)、复发(P=0.021)及高临床分期(P=0.027)的患者中明显高于对照组.窖蛋白-1表达在TTF-1阴性组的阳性率高于TTF-1阳性组(P =0.022),且两者表达呈负相关趋势(r=-0.154,P =0.037).窖蛋白-1阳性表达患者的5年累积生存率(32.7％)显著低于阴性患者(84.8％,P＜0.01),TTF-1阴性表达患者的5年累积生存率(21.6％)显著低于阳性患者(86.1％,P＜0.01).单因素生存分析显示,窖蛋白-1与TTF-1表达水平(P＜0.01)、组织学亚型(P =0.002)、危险度分级(P =0.002)、肿瘤最大径(P =0.009)、脉管侵犯(P =0.019)、淋巴结转移(P=0.018)、复发(P=0.032)及临床分期(P=0.024)是患者术后生存期的影响因素,而COX多因素分析显示窖蛋白-1阳性(P =0.043)、TTF-1阴性(P =0.003)及高危险度分级(P =0.028)的肺腺癌患者术后生存时间较短.结论 窖蛋白-1表达与肺腺癌组织学亚型及侵袭转移密切相关,对判断组织学起源和评估预后具有重要价值,窖蛋白-1阳性提示预后不良.

abstractsObjective To study the expression,clinicopathologic correlation and prognostic significance of caveolin-1 in lung adenocarcinomas (LAC).Methods Immunohistochemical study (EnVision method) for caveolin-1 and TTF-1 was carried out in 185 cases of LAC encountered during the period from 2005 to 2010.The correlation between caveolin-1 expression and various clinicopathologic parameters was analyzed statistically.Results The rate of caveolin-1 expression in the 185 cases of LAC was 26.5％ (49/185) and significantly lower than that in normal lung tissue (P ＜ 0.01).There was also higher rate of caveolin-1 expression in male patients (P =0.004),smokers (P =0.006),tumors larger than 3.5 cm (P =0.048),predominantly solid tumor subtype (P =0.025),high tumor grade (P =0.044),tumors with vascular invasion (P =0.019),lymph node metastasis (P =0.030),recurrence (P =0.021) and high clinical stage (P =0.027).The expression level of caveolin-1 in TTF1-negative cases was significantly higher than that in TTF1-positive cases and caveolin-1 expression also negatively correlated with TTF-1 expression in LAC (r =-0.154,P =0.037).The five-year overall survival rate of patients with caveolin-1 positive tumors was lower than that in caveolin-1 negative group (P ＜0.01).Univariate analysis indicated the expression level of caveolin-1 and TTF-1 (P ＜ 0.01),histologic subtype (P =0.002),tumor grade (P =0.002),tumor size (P =0.009),vascular invasion (P =0.019),lymph node metastasis (P =0.018),recurrence (P =0.032) and clinical stage (P =0.024) correlated with the survival of patients with LAC.COX multivariate analysis revealed that LAC with caveolin-1 positive expression,TTF-1 negative expression and high tumor grade carried a significantly unfavorable prognosis.Conclusion Caveolin-1 expression correlates with histologic subtype,tumor grade,invasiveness and metastatic potential of LAC.The detection of caveolin-1 in LAC is helpful in predicting prognosis.LAC with caveolin-1 expression carries a poor prognosis.