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背景与目的:人类Y盒结合蛋白,即YB-1蛋白是多功能蛋白之一,在转录与翻译两个水平调控基因表达,可作为预测人类恶性肿瘤多药耐药及判断预后的生物标记物。本文通过检测肺腺癌患者YB-1蛋白表达水平,评估YB-1蛋白在肺腺癌术后患者中的表达和对预后及复发的影响。方法:共收入174例接受肺腺癌切除术患者。其中99例男性,75例女性,平均年龄65.0岁(32~85岁)。采用S-P法进行免疫组织化学染色(抗YB-1多克隆抗体)。利用χ2检验进行统计学分析,Kaplan-Meier法绘制生存曲线,log-rank检验比较曲线间差异,Cox比例危险模型进行单因素及多因素分析。结果:在174例肺腺癌患者中,92例(52.9%)YB-1蛋白细胞质表达阳性。YB-1蛋白表达阳性组肿瘤细胞的分化较差(P=0.003),病理分期较晚(P<0.001),淋巴结转移较显著(P=0.005),肿瘤复发较早(P<0.001)。单因素及多因素分析表明,YB-1蛋白表达阳性组预后明显较YB-1蛋白表达阴性组差(总体生存风险分别为P<0.001和P=0.035)。此外,在对其中102例Ⅰ期肺腺癌患者各临床病理因子的多因素分析提示,YB-1蛋白表达阳性是预测患者预后不良及肿瘤早期复发的独立危险因子(分别为P=0.048,HR=2.370和P=0.057,HR=2.242)。结论:YB-1蛋白表达水平可作为预测肺腺癌术后患者(尤其是Ⅰ期肺腺癌患者)预后及复发的指标。
BACKGROUND & AIM: The human Y-box binding protein, YB-1 is a multifunctional protein that regulates gene expression at both transcriptional and translational levels and can be used as a biomarker to predict multidrug resistance and prognosis of human malignancies . In this paper, the expression of YB-1 protein in patients with lung adenocarcinoma and its effect on the prognosis and recurrence were evaluated by detecting the expression of YB-1 protein in patients with lung adenocarcinoma. METHODS: A total of 174 patients undergoing lung adenocarcinoma resection were enrolled. Of these, 99 were males and 75 were females with an average age of 65.0 years (32-85 years). Immunohistochemical staining using S-P method (anti-YB-1 polyclonal antibody). Statistical analysis was performed using χ 2 test, Kaplan-Meier survival curves were plotted, log-rank test was used to compare the differences between curves, and Cox proportional hazards model was used for univariate and multivariate analysis. Results: In 174 cases of lung adenocarcinoma, 92 (52.9%) YB-1 protein cytoplasm was positive. The positive expression of YB-1 protein in the positive group was poorly differentiated (P = 0.003). The pathological stage was later (P <0.001), lymph node metastasis was more significant (P = 0.005), and tumor recurrence was earlier (P <0.001). Univariate and multivariate analysis showed that the prognosis of YB-1 positive group was significantly lower than that of YB-1 negative group (overall survival risk was P <0.001 and P = 0.035, respectively). In addition, multivariate analysis of each clinicopathological factors in 102 patients with stage I lung adenocarcinoma suggested that the positive expression of YB-1 protein was an independent risk factor for predicting poor prognosis and early tumor recurrence (P = 0.048, HR = 2.370 and P = 0.057, HR = 2.242). Conclusion: The expression level of YB-1 protein can be used as a predictor of prognosis and recurrence in patients with lung adenocarcinoma after surgery (especially in patients with stage I lung adenocarcinoma).