Background: The aim of this study is to explore roles of thyroid transcription factor-1 (TTF-1), CD56, P40 expression and other clinical characteristics predicting response and survival in patients with small cell lung cancer (SCLC).
Methods: Formalin-fixed, paraffin-embedded biopsy tissues were retrospectively obtained from 198 SCLC patients who were diagnosed first in Xuanwu Hospital. The expressions of TTF-1, CD56 and P40 were detected by immunohistochemistry. The clinical data including age, gender, cancer stage, Eastern Cooperative Oncology Group (ECOG) score, smoking or not, superior vena cava syndrome (SVCS) due to lung cancer or not were collected. Cox proportional hazard model was used to analyze the relationship between the overall survival (OS) and factors.
Results: Immunohistochemical staining results showed the positive rate of TTF-1, CD56, P40 were 73.2%, 88.4% and 7.1% respectively. TTF-1 expression (OR=0.665, 95%CI: 0.472-0.937), smoking index ≤400 (OR=1.72, 95%CI: 1.061-2.789) and ECOG=2 (OR=3.551, 95%CI: 2.133-5.914), extensive-stage (OR=2.487, 95%CI: 1.793-3.451) and SVCS due to lung cancer (OR=2.394, 95%CI: 1.49-3.846) were independent prognostic factors for SCLC patients.
Conclusions: Prognosis of SCLC was related to TTF-1 expression independently after adjusting smoking, ECOG score, stage and SVCS due to lung cancer. Detection of TTF-1, CD56 and P40 expression level might be helpful for predict the prognosis of SCLC. .
背景与目的 本研究旨在分析甲状腺转录因子-1（thyroid transcription factor-1, TTF-1）、神经细胞粘附分子CD56和P40蛋白在小细胞肺癌患者中的阳性表达情况，探讨上述免疫表型标志物及其他临床特征与小细胞肺癌预后的相关性。方法 用免疫组织化学方法检测198例初次诊治的小细胞肺癌患者石蜡包埋活检组织标本中TTF-1、CD56、P40的阳性表达情况，观察随访患者临床特征及治疗、生存情况，通过Cox风险比例模型分析上述标志物、临床病理特征与预后的相关性。结果 198例小细胞肺癌患者TTF-1、CD56、P40的阳性率分别为 73.2%（145/198 ）、88.4%（175/198）、7.1%（14/198）。TTF-1是否阳性为小细胞肺癌患者独立预后因素OR=0.665，95%CI：0.472-0.937。其他与预后的相关因素包括：与不吸烟者相比，吸烟指数≤400组OR=1.72，95%CI：1.061-2.789；美国东部肿瘤协作组（Eastern Cooperative Oncology Group, ECOG）得分为2分与0分者相比的OR=3.551，95%CI：2.133-5.914；广泛期与局限期患者相比OR=2.487，95%CI：1.793-3.451；合并上腔静脉压迫综合征（superior vena cava syndrome, SVCS）者OR=2.394，95%CI：1.49-3.846。结论 小细胞肺癌中的预后与TTF-1表达及吸烟、ECOG得分、肿瘤分期、合并SVCS等多个因素相关，TTF-1、CD56、P40表达在小细胞肺癌的诊断和鉴别诊断中有辅助作用。.