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背景:肺腺癌干细胞是肺腺癌确诊的重要实验室依据,但其评估患者预后的价值如何,临床尚未定论。目的:探讨人肺腺癌干细胞表型与患者预后的关系。方法:选取2010年2月至2013年1月在新疆医科大学第一附属医院治疗的肺腺癌患者48例,采用免疫荧光法检测患者肺腺癌干细胞表型标志,比较不同表型与患者临床病例特征以及患者预后的关系。结果与结论:48例肺腺癌组织中均观察到SP-C表达和CCSP表达,具有肺细支气管肺泡干细胞的表型特征,其中34例同时表达OCT4(OCT4+支气管肺泡干细胞组),14例不表达OCT4(OCT4-支气管肺泡干细胞组)。OCT4+支气管肺泡干细胞组和OCT4-支气管肺泡干细胞组肺腺癌患者的年龄、性别、吸烟史以及肿瘤分期差异无显著性意义(P>0.05);OCT4+支气管肺泡干细胞组有23例(68%)患者癌细胞转移,明显高于OCT4-支气管肺泡干细胞组(21%),差异有显著性意义(P<0.05);在腺癌患者年龄、性别、吸烟史、分期以及癌细胞转移等临床病理特征分层中,OCT4-支气管肺泡干细胞组肺腺癌2年生存率普遍高于OCT4+支气管肺泡干细胞组,两组生存曲线差异有显著性意义(P<0.05)。结果表明人肺腺癌干细胞具有肺细支气管肺泡干细胞表型特征,同时表达胚胎干细胞基因OCT4时,患者预后差,与肺腺癌转移有关。
BACKGROUND: Lung adenocarcinoma stem cells are an important laboratory basis for the diagnosis of lung adenocarcinoma. However, its value in assessing the prognosis of patients has not been determined clinically. Objective: To investigate the relationship between the phenotype of human lung adenocarcinoma stem cells and the prognosis of patients. Methods: Forty-eight patients with lung adenocarcinoma who were treated in the First Affiliated Hospital of Xinjiang Medical University from February 2010 to January 2013 were enrolled. The phenotypes of lung adenocarcinoma stem cells in patients were detected by immunofluorescence. The clinical features of patients with different phenotypes were compared Case characteristics and prognosis of patients. RESULTS AND CONCLUSION: SP-C expression and CCSP expression were observed in 48 cases of lung adenocarcinoma. The phenotypes of lung bronchioalveolar stem cells were observed. Among them, 34 cases expressed both OCT4 (OCT4 + bronchoalveolar stem cell group) and 14 cases Expression of OCT4 (OCT4-bronchoalveolar stem cell group). There was no significant difference in age, sex, smoking history and tumor staging between OCT4 + bronchoalveolar stem cell group and OCT4 - bronchoalveolar stem cell group (P> 0.05); 23 (68%) patients in OCT4 + bronchoalveolar stem cell group The metastasis of cancer cells was significantly higher than that of OCT4-bronchoalveolar stem cell group (21%) (P <0.05). The clinical features of adenocarcinoma including age, sex, smoking history, staging and cancer metastasis Layer, the 2-year survival rate of lung adenocarcinoma of OCT4-bronchoalveolar stem cell group was generally higher than that of OCT4 + bronchoalveolar stem cell group, and there was significant difference between the two groups (P <0.05). The results showed that human lung adenocarcinoma stem cells have phenotypic characteristics of pulmonary bronchial alveolar stem cells, while the expression of embryonic stem cells gene OCT4, the poor prognosis of patients with lung adenocarcinoma metastasis.