摘要
目的：探讨P-gp、p21~(ras)、CD44v6在肺癌中表达及其临床病理意义，以期为肺癌的诊治提供新的思路。
方法：本课题运用免疫组织化学技术(SP法)检测了P-gp、p21~(ras)、CD44v6在79例肺癌中的表达情况，分析它们与临床病理特征的关系；对随访资料齐全的55例用Stata统计软件包的Kaplan-Meier和Cox模型进行生存分析。并以11例癌旁肺组织作对照。
结果：
1．本组肺癌P-gp、p21~(ras)、CD44v6表达阳性率分别为74.69％(59/79)、84.81％(67/79)、51.90％(41/79)。
2．P-SP、p21~(ras)、CD44v6表达与肺癌组织学类型关系密切(P＜0.05)，与患者年龄、性别、吸烟、淋巴结转移、预后等临床病理特征无明显关系。
3．P-Sp与p21~(ras)、P-gp与CD44v6、p21~(ras)与CD44v6共同阳性表达率分别为67.09％(53/79)、43.04％(34/79)、45.57％(36/79)，其中P-gp与p21~(ras)表达呈具有相关性。
4．p21~(ras)表达在肿瘤体积较小组(直径≤3cm)中全为阳性(21/21)，而肿瘤体积较大组(直径＞3cm)阳性表达率为79.31％(46/58)，二者之间差异具有显著性(P＜0.05)。
5．COX风险模型分析显示临床分期(TNM)是判断肺癌预后的独立性指标。
结论：
1．P-gp、p21~(ras)、CD44v6表达均与肺癌的组织学类型有关。
2．P-gp与p21~(ras)在肺癌中表达具有正协同作用。
3．CD44v6在肿瘤中表达的意义及其作用机制尚有待于进一
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步探讨。
4．肺癌临床分期（TNM）可作为判断肺癌预后的独立性指标。
5．PEp、pZI『皿、CD44V6不是肺癌预后的独立性指标。
ObjectiveiTo investigate the relationship of the expression of P-gp, p21ras and CD44v6 in primary lung carcinoma and their clinicopathological significance. In order to offer a new idea to diagnosis, prevent and treat primary lung carcinoma.
Methods: The expression of P-gp, p21ras and CD44v6 were investigated by immunohistochemical SP method in 79 cases of primary lung carcinoma. The relationships were also analysed between the results and clinicopathological features. 55 cases with following-up data were studied by Kaplan-Meier survival Curve and the Cox regression analysis. 11 cases of adjacent tissues acted as control group.
Results:
1. Of the 79 cases primary lung carcinoma, the rates of expression of P-gp, p21ras and CD44v6 was 74.69% (59/79) , 84.81% (67/79) and 51.09% (41/79) respectively.
2. The expression of P-gp, p21ras and CD44v6 were related to the different sorts of primary lung carcinoma (P < 0.05) . There was no marked significance relation to age, sex, smoke, metastasis of lymph nodes, as well as prognosis.
3. The co-positive-expression rates of P-gp and p21ras ,P -gp and p21ras and, p21ras and CD44v6 was 67.09%(53/79), 43.04% (34/79) , 45.57%(36/79) respectively , a significant correlation was observed between P-gp and p21ras.
4. All of 21 cases which sizes were not more than 3cm (Diameter ^3 cm) expressed p21ras, but the expressive rates of those which sizes were more than 3cm (Diameter>3cm) only 79.31 %(48/56) (P < 0.05) .
5. The results of multivariate analysis by the Cox proportional hazards model showed that TNM stage was an independent prognostic indicator.
Conclusions:
1. There is a significant relationship between the expression of P-gp, p21ras and CD44v6 and the different sorts of primary lung carcinoma (P<0.05) .
2. There is a cooperative action between the expressions of P-gp and the expressions of p21ras.
3. The significance and its mechanism of the expression of CD44v6 in primary lung carcinoma should be further studied.
4. TNM stage is an independent prognostic indicator for primary lung cancer.
5. The expressions of P-gp. p21ras and CD44v6 are not an independent prognostic factor of primary lung carcinoma.
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