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Beclin-1和Bcl-2表达与非小细胞肺癌患者病理特征及预后间关系的研究

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  • 1.上海交通大学医学院附属瑞金医院胸外科,上海 200025
    2.上海交通大学医学院附属瑞金医院北院a. 呼吸科,b. 病理科,上海 201801

收稿日期: 2020-01-20

  网络出版日期: 2020-06-25

基金资助

上海市嘉定区卫健委课题(2017KY02)

The prognostic value of Beclin-1 and Bcl-2 and its relationship with pathological characteristics in patients with non-small cell lung cancer

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  • 1. Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    2a. Department of Respiratory Medicine, b. Department of Pathology, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 201801, China

Received date: 2020-01-20

  Online published: 2020-06-25

摘要

目的: 检测非小细胞肺癌(non-small cell lung cancer,NSCLC)组织中Beclin-1和Bcl-2蛋白的表达,分析其与患者临床病理特征及预后间的关系,探讨Beclin-1和Bcl-2蛋白检测在NSCLC疾病发展及预后评估中的应用价值。方法: 采用免疫组织化学(免疫组化)染色法检测120例经外科手术切除的NSCLC组织及配对癌旁组织中Beclin-1和Bcl-2蛋白的表达情况,分析其与患者疾病进展及预后间的关系。结果: Beclin-1蛋白在癌旁组织中的高表达率显著高于NSCLC组织(49.2%比31.7%,P<0.01);而Bcl-2蛋白在NSCLC组织中的高表达率显著高于癌旁组织(45.8%比21.7%,P<0.01)。Beclin-1蛋白的表达情况与NSCLC的分化程度、病理分期及淋巴结转移有关,NSCLC患者的肿瘤分化程度越差、病理分期越高及存在淋巴结转移,Beclin-1蛋白的表达量也越低(P<0.05);Bcl-2蛋白的表达量则与NSCLC的肿瘤分化程度及淋巴结转移有关,肿瘤分化程度越差或存在肿瘤淋巴结转移,则Bcl-2蛋白的表达量越高(P<0.05)。Beclin-1和Bcl-2蛋白的表达与患者年龄、性别、吸烟、术前血清癌胚抗原(carcinoembryonic antigen,CEA)水平及肿瘤病理类型无关(P>0.05)。多因素 Cox风险比例回归分析结果显示,NSCLC的肿瘤细胞分化越差、病理分期越高及Beclin-1蛋白表达量越低可作为NSCLC患者预后差的独立标志物(P分别为<0.05、<0.01、<0.01)。NSCLC组织Bcl-2蛋白高表达组中,Beclin-1蛋白高表达者较低表达患者有更好的5年术后总生存率,差异有统计学意义(P<0.01)。结论: NSCLC患者肿瘤组织中自噬活性下降,Beclin-1蛋白低表达、Bcl-2蛋白高表达与NSCLC的发生及进展有关。高Beclin-1可作为Bcl-2蛋白高表达NSCLC患者的较好的独立预后标志物。

本文引用格式

杜海磊, 陈聆, 罗方秀, 李勇, 程齐俭, 朱良纲, 杭钧彪 . Beclin-1和Bcl-2表达与非小细胞肺癌患者病理特征及预后间关系的研究[J]. 诊断学理论与实践, 2020 , 19(03) : 258 -263 . DOI: 10.16150/j.1671-2870.2020.03.010

Abstract

Objective: To evaluate Beclin-1 and Bcl-2 in the prognosis of non-small cell lung cancer (NSCLC) by analyzing the expression of the two markers and clinical/pathological characteristics of patients. Methods: A total of 120 paired cancerous and paracancerous tissue samples from NSCLC patients were collected from surgical procedures and expressions of Belin-1 and Bcl-2 protein was determined with immunohistochemical analysis. The correlation between Belin-1 and Bcl-2 and the clinical/pathological characteristics of the patients was studied. Results: The high expression rate of Beclin-1 in the paracancerous tissues was significantly higher than that in the cancer tissues (49.2% vs 31.7%, P<0.01), while Bcl-2 in paracancerous tissues was significantly lower than that in cancer tissues (21.7% vs 45.8%, P<0.01). The lower expression of Beclin-1 in NSCLC was associated with poor differentiation, advanced pathological stage and lymph node metastasis(P<0.05). Higher Bcl-2 expression rate was correlated with poor differentiation and lymph node metastasis (P< 0.05). Neither Beclin-1 or Bcl-2 expression in lung cancer tissues was associated with age, gender, smoking, preope-rative serum CEA and tumor pathological type (P>0.05). Multivariate Cox regression analysis showed that advanced pathological stage, the lower the expression of Beclin-1,and poor differentiation were independent predictors of poor prognosis in patients with NSCLC (P<0.05, P<0.01, P<0.01). In patients with high expression of Bcl-2, high Beclin-1 expression was related to a better 5-year survival (P<0.01). Conclusions: The fuction of autophagy activity in NSCLC is decreased. Lower Beclin-1 expression and higher expression of Bcl-2 are found in NSCLC tissues, and both of them are associated with occurrence and progress of NSCLC. High Beclin-1 may serve as a favorable prognostic marker independently for NSCLC patients with high Bcl-2 expression.

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