The Expression Of DNA Topoisomerase Ⅱa In Lung Adenocarcinoma And Squamous Carcinoma And Its Prognosis In Patients

Objective:Analyzing and discussing the expression of DNA topoisomerase Ⅱa(DNA Top Ⅱa)in lung tumors and its relation with prognosis.It also provides a basis for evaluating the prognosis of lung tumor patients.Information and methodology:Systematically reviewing the clinical data of 423 patients with lung tumors undergoing surgical treatment in the first hospital attached to Dalian University,from January 2013 to August 2016.The follow-up method was telephone follow-up.The end date of follow-up was June 2018.The clinical data of 423 patients were complete,including sex,age,history of smoking,tumor size,pathological type,degree of tumor differentiation,the eighth edition of the United International Cancer Control(UICC)TNM staging,pleural invasion,etc.No radiotherapy or chemotherapy was performed in the group before surgery,and hemoxylin-eosin staining(HE staining)and immunohistochemical methods were used to detect the pathological sections of tumors in the patients after surgery.The expression of DNA Top Ⅱa in tumor cells in each patient was detected by HE staining and immunohistochemistry.To summarize the expression,they are grouped according to the positive expression rate.The unexpressed and expressed positive rate of <25 % is then defined as a low expression group,and the remaining expression results are defined as a high expression group.According to the above grouping,the sex,age,tumor size,pathological type,tumor differentiation degree,TNM stage,pleural invasion and so on were statistically analyzed.Using SPSS21.0 statistical software to process the data.The relationship between the expression of DNA topoisomerase Ⅱa and clinical factors was analyzed by the method of χ2 test and Fisher’s exact probability method.The survival data draws the Kaplan-Meier survival curve and uses the Cox regression ratio risk model to analyze the single factor and multiple factors,P<0.05 is considered statistically significant.Results:Among the 423 patients with postoperative lung cancer,199(47.0%)were male and 224(53%)were female.There were 217(51.6%)patients with age ≦62 and206(48.4%)patients with age >62.There were 68(16.1%)smoking patients and 355(83.9%)non-smoking patients.DNA topoisomerase Ⅱa lower expression of 322(76.1%)cases,DNA topoisomerase Ⅱa high expression of 101(23.9%).There were341(80.6%)patients with tumor size ≦ 3cm and 82(19.4%)patients with tumor size >3cm.There were 282(66.7%)cases without pleural invasion and 141(33.3%)cases with pleural invasion.According to the statistical analysis of the data,the results showed that DNA topoisomerase Ⅱa had correlation with a degree of tumor differentiation(P < 0.001),the pathological types(P < 0.001),tumor size(P < 0.001),and TNM staging(P = 0.026),but had no no significant correlation with and gender(P= 0.067),age(P = 0.111),with or without smoking history(P = 1.000),the presence of pleural invasion(P = 0.718).Cox proportional hazards regression model was used to423 cases of patients with single factor analysis found that DNA Top Ⅱa high expression(HR = 3.968,95% CI,2.204 to 7.144,P < 0.001),male patients(HR =2.967,95% CI 1.674 to 5.257,P < 0.001),the tumor > 3 cm(HR = 4.533,95% CI2.542 to 8.082,P < 0.001),low degree of tumor cell differentiation(HR = 2.987,95%CI 1.255-7.109,P=0.013),late TNM stage(HR=2.714,95%CI 1.519-4.846,P=0.001),and open thoracic surgery(HR=3.696,95% CI 2.084-6.557,P<0.001)were risk factors for patient survival,but the patient’s age,smoking history,pleural invasion of tumor and pathological type did not affect the patient’s survival risk.The related results into multiple factors analysis,the results showed that DNA Top Ⅱ a high expression(HR =2.431,95% CI,1.278 to 4.622,P = 0.007),tumor diameter greater than 3 cm(HR =2.415,95% CI,1.288 to 4.528,P = 0.006),open chest surgery(HR = 2.018,95% CI,1.069 to 3.810,P = 0.030)is still the survival in patients with risk factors,are independent risk factors affect the prognosis of patients.Conclusion:The expression of DNA topoisomerase Ⅱa is different in lung adenocarcinoma and squamous carcinoma and it is an independent risk factor that affects the prognosis of patients.