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[目的]探讨中晚期肺腺癌患者在化疗前癌组织中Nanog的表达,以及其与化疗疗效及预后的关系.[方法]收集2010年1月至2013年12月本科收治的经组织病理学确诊的中晚期肺腺癌56例患者的病理资料,所有患者均完成至少四个周期的培美曲塞联合顺铂化疗.采用免疫组化法检测所有癌组织中Nanog的表达水平.[结果]56例中晚期肺腺癌患者的癌组织中Nanog蛋白高表达者29例(51.8％),低表达者27例(48.2％),其表达高低与患者性别(P=0.643)、年龄(P=0.143)、临床分期(P=0.096)均无相关性.Nanog高表达组化疗有效率(24.1％)低于低表达组化疗有效率(70.4％),差异有统计学意义(P＜0.05).单因素分析结果表明临床分期和Nanog的表达水平与肺腺癌患者的临床预后相关(P均＜0.05),多因素分析显示Nanog表达水平是肺腺癌患者的预后独立影响因素(P＜0.05).[结论]Nanog高表达有可能预测着肺腺癌患者对培美曲塞联合顺铂化疗疗效不佳以及更差临床预后.“,”[Objective]To investigate the expression of Nanog in cancer tissue before chemotherapy in advanced lung adenocarcinoma and its influence on the chemotherapeutic effect and prognosis.[Methods] Pathological data of fifty-six advanced lung adenocarcinoma cases confirmed by histopathology between January 2010 and December 2013 in our hospital was collected.All patients completed at least four cycles of pemetrexed chemotherapy combined with cisplatin.The expression of Nanog was detected by immunohistochemistry in all cancer tissues.[Results] High expression of Nanog protein in cancer tissue occurred in 29 cases (51.8 ％) out of 56 cases of advanced lung adenocarcinoma,low expression in 27 cases (48.2％);There was no correlation between the expression level and the gender of the patients (P =0.643),age (P =0.143) and clinical stage (P=0.096);the efficiency of chemotherapy (24.1％) in the Nanog high expression group was lower than that of the low expression group (70.4％),the difference was statistically significant (P ＜0.05).Univariate analysis showed that clinical stage and Nanog expression levels were associated with clinical prognosis in patients with lung adenocarcinoma (P mean ＜0.05);Multivariate analysis showed that Nanog expression was an independent prognostic factor in patients with lung adenocarcinoma (P ＜0.05).[Conclusion] Nanog high expression may indicate a poor response to pemetrexed chemotherapy combined with cisplatin in patients with lung adenocarcinoma,and even a worse clinical outcome.