LIMD2蛋白在手术切除的非小细胞肺癌中表达及临床意义

发布时间：2018-03-24 05:37

本文选题：LIMD2蛋白　切入点：非小细胞肺癌　出处：《第二军医大学》2017年硕士论文

【摘要】：目的:探讨LIMD2蛋白在手术切除的非小细胞肺癌中的表达及临床意义。方法:收集福州总医院2010年10月至2014年7月经手术切除的NSCLC 141例,癌旁组织25例。使用HE染色对标本中的肿瘤组织进行检测,使用扩增阻滞法(AMRS法)和实时荧光(PCR法)对肿瘤组织中的EGFR突变状态进行检测。采用免疫组化法对组织中的LIMD2蛋白及E钙黏素进行检测。Ki-67和VEGF在肿瘤组织中的表达以本院免疫组化报告为准。LIMD2蛋白与临床病理参数的关系采用卡方检验,DFS用Kaplan-Meier生存曲线述,LIMD2蛋白与E钙粘素关系采用Spearman秩和检验,单因素和多因素COX回归分析LIMD2蛋白、E钙粘素和各病理参数与NSCLC术后DFS关系。采用双侧检验,P0.05认为有统计学意义。结果:患者年龄分布27-80岁,中位发病年龄60岁。术后进展105(74.5%)例,无进展36(25.5%)例,术后DFS2.8-64.3个月,中位DFS15.9个月。腺癌84(59.6%)例,鳞癌57(40.4%)例,肿瘤细胞高中分化96例(68.1%),低分化45例(31.9%)。Ki-67高表达79例(56.0%),低表达62例(44.0%),Ki-67高表达在肺鳞癌(P=0.002)和低分化的肿瘤中更常见(P=0.000)。VEGF高表达74例(52.5%),低表达67例(47.5%),VEGF高表达在肺腺癌中更常见(P=0.042)。EGFR突变43例(30.5%),野生型98例(69.5%),EGFR突变在女性(P=0.023)和腺癌中常见(P=0.000)。Ki-67、VEGF的表达水平和EGFR突变状态与术后DFS无关。LIMD2在肿瘤组织中高表达71例(50.4%),低表达70例(49.6%),在癌旁组织中高表达7例(28.0%),低表达18例(72.0%),LIMD2在肿瘤组织中高表达较癌旁组织常见。E钙黏素在肿瘤组织中高表达75例(53.2%),低表达66例(46.8%),在癌旁组织中高表达13例(52.0%),低表达12例(48.0%),E钙黏素在两种组织中表达无差异。肿瘤组织中LIMD2表达水平在不同N、TNM分期及肿瘤分化程度方面存在差异,LIMD2高表达常见于术后DFS短的患者中(P=0.033)。E钙黏素表达水平在不同的T、N及TNM分期中表达水平存在差异,E钙黏素高表达在术后较长的DFS患者中常见(P=0.000)。在癌组织中LIMD2表达水平与E钙黏素表达水平呈负相关(R=-0.42,P=0.000)。多因素回归分析表明性别、T分期、TNM分期、肿瘤分化程度、LIMD2及E钙黏素表达与NSCLC术后DFS相关。结论:在NSCLC中LIMD2可能抑制E钙黏素表达,LIMD2在肿瘤组织中表达越高术后DFS越短,LIMD2或许可以作为预测NSCLC术后复发的生物标志物。
[Abstract]:Objective: to investigate the expression and clinical significance of LIMD2 protein in surgical resection of non-small cell lung cancer (NSCLC). Methods: 141 cases of NSCLC were surgically resected from October 2010 to July 2014 in Fuzhou General Hospital. He staining was used to detect tumor tissues in 25 cases of paracancerous tissues. The mutation status of EGFR in tumor tissues was detected by Amplification Block Assay (Amr) and Real time fluorescence PCR (RT PCR). Immunohistochemical method was used to detect LIMD2 protein and E-cadherin in tumor tissues. Ki-67 and VEGF were detected on the surface of tumor tissues. The relationship between LIMD2 protein and clinicopathological parameters was studied by chi-square test. The relationship between LIMD2 protein and E-cadherin was described by Kaplan-Meier survival curve. Spearman rank sum test was used to test the relationship between LIMD2 protein and E-cadherin. Univariate and multivariate COX regression analysis showed that LIMD2 protein E cadherin and pathological parameters were correlated with DFS after NSCLC. Bilateral test (P0.05) showed that there was statistical significance. Results: the age distribution of the patients was 27-80 years old, the median age of onset was 60 years old, and the postoperative progression was 105% 74.5% (P < 0.05). No progress was found in 36 cases, DFS2.8-64.3 month after operation, median DFS15.9 month, adenocarcinoma 849.6 cases, squamous cell carcinoma 5740.4). High expression of Ki-67 in 79 cases, high expression of Ki-67 in 62 cases, high expression of Ki-67 in 62 cases, high expression of P0. 0000. 002 in lung squamous cell carcinoma, high expression of P0.000.VEGF in 74 cases of poorly differentiated tumors, low expression of VEGF in 67 cases of lung adenocarcinoma, and low expression of VEGF in 67 cases of lung adenocarcinoma. The expression level of EGFR and EGFR mutation were not related to the postoperative DFS. LIMD2 was not related to the expression of DFS in tumor tissues. LIMD2 was highly expressed in tumor tissues in 71 cases, and low expression in 70 cases (49.6%), and was high in the adjacent tissues of carcinoma. The expression of EGFR mutation was not related to the expression of DFS in the tumor tissues after operation, while the expression of EGFR mutation in wild type 98 cases was 69.5%, and the expression level of EGFR mutation was high in the adjacent tissues of the carcinoma. The level of EGFR mutation was not related to the postoperative DFS. LIMD2 was highly expressed in the tumor tissues of 71 cases, and the low expression of 70 cases was 49.6% in the adjacent tissues. The high expression of LIMD2 in tumor tissues was higher than that in paracancerous tissues. There were 75 cases with high expression of E-cadherin in tumor tissues, 66 cases with low expression of calcitonin, 13 cases with high expression of LIMD2 in adjacent tissues, and 12 cases with low expression of E-cadherin in paracancerous tissues. There was no difference in the expression of LIMD2 between the two kinds of tissues. There were differences in the expression of LIMD2 in different tumor stages and tumor differentiation. The high expression of LIMD2 was more common in patients with short DFS after operation than in the patients with short DFS. There was significant difference in the expression of E-cadherin in TNM stage. The high expression of E-cadherin was common in patients with long postoperative DFS. There was a negative correlation between LIMD2 expression and E-cadherin expression in cancer tissues. Multivariate regression analysis showed that sex T staging was associated with TNM stage. The expression of LIMD2 and E-cadherin is related to the expression of E-cadherin after NSCLC. Conclusion: LIMD2 may inhibit E-cadherin expression in NSCLC. The higher the expression of LIMD2 in tumor tissues, the shorter DFS expression. LIMD2 may be a biomarker for predicting the recurrence of NSCLC.
【学位授予单位】：第二军医大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2

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