CyclinD1、p27在非小细胞肺癌中的表达及与临床病理特征、术后复发的关系

Expressions of cyclinD1 and p27 in NSCLC and their relationships with clinicopathological features, postoperative recurrence

摘要:

目的 检测非小细胞肺癌（NSCLC）患者癌组织细胞周期蛋白D1（CyclinD1）、p27蛋白的表达，探讨其与临床病理特征、术后复发的关系。方法 回顾性分析125例NSCLC患者的临床资料。125例患者均手术切除，术后以免疫组织化学SP法检测癌组织与癌旁组织CyclinD1、p27蛋白的表达；比较不同临床病理特征患者癌组织CyclinD1、p27蛋白的阳性表达率；随访并统计复发率，对比复发者和未复发者癌组织CyclinD1、p27蛋白表达；采用Cox逐步回归分析探讨癌组织CyclinD1、p27蛋白表达与术后复发的关系。结果 癌组织CyclinD1蛋白阳性表达率高于癌旁组织（P <0.05），p27蛋白阳性表达率低于癌旁组织（P <0.05）；Ⅲa期、低分化患者癌组织CyclinD1蛋白阳性表达率高于Ⅰ、Ⅱ期，中高分化患者，p27蛋白阳性表达率低于Ⅰ、Ⅱ期、中高分化患者（P <0.05）；术后复发率为63.20%，复发患者癌组织CyclinD1蛋白阳性表达率高于未复发患者（P <0.05），p27蛋白阳性表达率低于未复发患者（P <0.05）；复发NSCLC患者临床Ⅲa期、低分化、癌组织CyclinD1蛋白阳性表达、癌组织p27蛋白阴性表达占比均高于未复发患者（P <0.05），淋巴结清扫、术后放化疗占比均低于未复发患者（P <0.05）；Cox逐步回归分析发现，临床Ⅲa期［O^R=5.818（95% CI：1.926，6.981）］、低分化［O^R=6.613（95% CI：2.507，7.669）］、癌组织CyclinD1蛋白阳性表达［O^R=7.199（95% CI：2.147，7.958）］、癌组织p27蛋白阴性表达［O^R=5.339（95% CI：2.209，5.869）］均是NSCLC患者复发的独立危险因素（P <0.05），而淋巴结清扫［O^R=0.477（95% CI：0.341，0.597）］、术后放化疗［O^R=0.486（95% CI：0.322，0.674）］均是其保护因素（P <0.05）。结论 NSCLC患者癌组织CyclinD1蛋白阳性表达率高于癌旁组织，p27蛋白阳性表达率低于癌旁组织，并且与病理分期、分化程度、术后复发有关。癌组织CyclinD1蛋白阳性表达、癌组织p27蛋白阴性表达与临床IIIa期等均是术后复发的独立危险因素，淋巴结清扫、术后放化疗是其保护因素。

Abstract:

Objective To detect the expressions of cell cycle protein D1 (CyclinD1) and p27 protein (p27) in non small cell lung cancer (NSCLC), and to explore the relationships of CyclinD1 and p27 with clinicopathological features and postoperative recurrence.Methods The clinical data of 125 NSCLC patients were reviewed. All patients underwent surgical resection. The expressions of CyclinD1 and p27 proteins were detected by immunohistochemistry SP method after operation. The expressions of these proteins in cancer tissues of patients with different clinicopathological characteristics were compared. The expressions of CyclinD1 and p27 protein in recurrent and non recurrent cancer tissues were compared. The relationships of the expression of CyclinD1 and p27 proteins with postoperative recurrence with Stepwise Cox regression analysis were defined.Results The positive expression rate of cyclinD1 protein in cancer tissue was higher than that in adjacent tissues (P < 0.05), and the positive expression rate of p27 protein was lower than that of adjacent tissues (P < 0.05). The positive expression rates of cyclinD1 protein in cancer tissues of IIIa stage and low differentiation patients were higher than those of I, II stage and middle and high differentiation patients, and the positive expression rates of p27 protein were lower than those of Ⅰ, Ⅱ stage and middle and high differentiation patients (P < 0.05). The recurrence rate was 63.20%. The positive expression rate of CyclinD1 protein in recurrent cancer was higher than that in non recurrent cancer (P < 0.05), and the positive expression rate of p27 protein was lower than that of patients without recurrence (P < 0.05). The patients with recurrent NSCLC of those with clinical IIIa stage, low differentiation, positive expression of CyclinD1 protein and negative expression of p27 protein were higher than those without recurrence (P < 0.05), and the proportions of lymph node dissection and postoperative radiotherapy and chemotherapy in patients with recurrence were lower than those in patients without recurrence (P < 0.05). Stepwise Cox regression analysis showed that clinical Ⅲa stage [O^R = 5.818 (95% CI: 1.926, 6.981)], low differentiation [O^R = 6.613 (95% CI: 2.507, 7.669) ], positive expression of cyclinD1 protein [O^R = 7.199 (95% CI: 2.147, 7.958) ], and negative expression of p27 protein [O^R = 5.339 (95% CI: 2.209, 5.869) ] were risk factors independent risk factors of postoperative recurrence, and lymph node dissection [O^R = 0.477 (95% CI: 0.341, 0.597) ] and postoperative radiotherapy and chemotherapy [O^R = 0.486 (95% CI: 0.322, 0.674) ] were protective factors.Conclusion The positive expression rate of CyclinD1 protein in NSCLC is higher than that in adjacent tissues, and the positive expression rate of p27 protein is lower than that in adjacent tissues. They are closely related to pathological stage, degree of differentiation and postoperative recurrence. The positive expression of CyclinD1 protein in cancer tissues, the negative expression of p27 protein in cancer tissues, and clinical IIIa stage are independent risk factors for recurrence, while lymph node dissection, postoperative radiotherapy, and chemotherapy are the protective factors.