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目的:探讨黑色素瘤相关抗原(melanoma antigen,MAGE)-As在非小细胞肺癌(Non-small cell carcinoma,NSCLC)组织中的表达,并分析其与临床病理学特征和预后的关系。方法:选取河北医科大学第四医院2015年9月至2016年3月住院手术切除的NSCLC组织及相应癌旁组织标本90例,应用免疫组织化学法检测NSCLC组织及相应癌旁组织中MAGE-As蛋白的表达,分析MAGE-As蛋白表达与NSCLC临床病理指标之间的相关性;利用荧光原位杂交技术检测EGFR基因扩增和ALK基因重排情况,Spearman检验MAGE-A表达与EGFR扩增和ALK重排的关系;应用Kaplan-Meier方法对NSCLC患者是否阳性表达MAGE-As蛋白进行生存分析,利用Cox回归模型针对阳性表达MAGE-As及相关的临床病理资料进行单因素和多因素分析。结果:NSCLC组织中MAGE-As蛋白的阳性表达率明显高于癌旁组织(P<0.05)。MAGE-As蛋白的表达与患者的临床病理学特征、EGFR扩增和ALK重排均无关联(P>0.05)。MAGE-As蛋白表达阳性的NSCLC患者生存期显著低于其表达阴性患者(P<0.05),而EGFR扩增和ALK重排与患者的整体生存率无关(P>0.05)。多因素分析结果显示,MAGE-As表达、临床分期和淋巴结转移是NSCLC患者较差预后的独立危险因素。结论:MAGE-As蛋白是NSCLC的相关抗原,MAGE-As蛋白可作为NSCLC患者预后不良的预测指标。
Objective: To investigate the expression of melanoma antigen (MAGE) -As in non-small cell carcinoma (NSCLC) tissues and to analyze its relationship with clinicopathological features and prognosis. Methods: Totally 90 NSCLC tissues and corresponding para-cancerous specimens of hospitalized patients in the Fourth Hospital of Hebei Medical University from September 2015 to March 2016 were selected for immunohistochemical detection of MAGE-As Protein expression and analyze the relationship between MAGE-As protein expression and clinicopathological features of NSCLC. Fluorescence in situ hybridization was used to detect the amplification of EGFR gene and ALK gene rearrangement. ALK rearrangement. Kaplan-Meier method was used to analyze whether MAGE-As protein was positively expressed in NSCLC patients. Cox regression model was used to analyze single-factor and multi-factor analysis of MAGE-As and related clinicopathological data. Results: The positive rate of MAGE-As protein in NSCLC tissues was significantly higher than that in adjacent non-cancerous tissues (P <0.05). The expression of MAGE-As protein had no correlation with the clinicopathological features, EGFR amplification and ALK rearrangement (P> 0.05). The survival of NSCLC patients with MAGE-As protein expression was significantly lower than that of patients with negative expression of MAGE-As (P <0.05). However, EGFR amplification and ALK rearrangement had no correlation with overall survival (P> 0.05). Multivariate analysis showed that MAGE-As expression, clinical stage and lymph node metastasis were independent risk factors for poor prognosis in patients with NSCLC. Conclusion: MAGE-As protein is a related antigen in NSCLC. MAGE-As protein may be used as a predictor of poor prognosis in patients with NSCLC.