The Expression Of PTEN, FAK In Bronchioloalveolar Carcinoma And Adenocarcinoma And Their Clinical-pathological Significance

Objective: To clarify the roles of expression PTEN,FAK and E-Cadherin in thebiological behavior and prognosis of bronchioloaveolar carcinoma (BAC) and lung adenocarcinoma, and investigate the mechanism of the development from BAC to adenocarcinoma.Method: Clinic data of 82 cases (33 BAC cases, and 49 adenocarcinoma cases) inTianjin Cancer Hospital from January 2001 to December 2002,were retrospectively reviewed. Immunohistochemical staining was used to determine the expression of PTEN,FAK and E-Cadherin in all of the cases.Results:1. Results of clinical dataThe overall 1,3 and 5-year survival rate of BAC were 90.9%, 78.8% and 66.7%; and that of adenocarcinoma were 79.6 %, 55.1% and 38.8 %, respectively. The main prognostic factors were pathologic types (P-0.000) , TNM stage (P=0.000) ,T stage (P=0.000) and N stage(P=0.000). Age (more than 60 years or not), gender, clinical symptom, the location of the mass, surgical intervention were not significant prognostic factors (P>0.05). Cox regression analysis suggested that the TNM stage (P=0.040), PTEN expression (P=0.000) and pathological type (P=0.000) were independent factors for the prognosis.2. The expression of PTEN,FAK and E-Cadherin in BAC and adenocarcinom and their significanceThe positive incidence of PTEN,FAK and E-Cadherin in BAC and adenocarcinoma were 54.5%,54.5%,21.2% and 59.2%, 87.8%, 32.7% respectively. Over expression of FAK was correlated with adenocarcinoma type, TNM stage and lymph node involvement (P<0.05), but was not associated with the prognosis. Strata analysis suggested that PTEN positive group had a higher 5 year survival rate than negative group, both in BAC and adenocarcinoma groups (P<0.05). The univariate analysis revealed that tumor size, N stage, TNM stage, pathological subtype, and PTEN expression were significant correlative factors with prognosis. The result of multivariate Cox analysis showed that N stage, TNM stage, pathological subtype and PTEN expression were independent prognostic factors. A significant positive correlation was observed between PTEN expression and FAK expression (r=0.228, P=0.039).Conclusion: BAC was an important subtype of lung adnenocarcinoma, withspecial clinical pathologic presentation and biological behavior. The BAC had a better prognosis than adenocarcinoma. The expression incidence of FAK was superior in adenocarcinoma than BAC, and was associated with lymph node invasion. However there was no relationship between FAK expression and prognosis. Over expression of FAK participated in the invasion of cancer cells and probably played a role in the development from BAC to adenocarcinoma. PTEN expression is an important prognostic factor for both BAC and adenocarcinoma. A positive correlation was observed between the expression of PTEN and FAK. PTEN expression, TNM stage and pathologic subtype were independent prognostic factors for BAC and adenocarcinoma.