The Prognostic Significance Of Epithelial And Mesenchymal Proteins In Resected Stage Ⅲa Non-Small-Cell Lung Carcinoma

ObjectiveResearches show that the transition between epithelial and mesenchymal tissue is the key progress of tumor's recurrence and metastasis.It is found that epithelial proteins E-Cadherin andβ-catenin and mesenchymal proteins vimentin and fibronectin play vital roles in this transition.The research investigated the clinical significance of E-Cadherin,β-catenin,vimentin and fibronectin as prognostic factors in stageⅢa Non-Small-Cell Lung Carcinoma(NSCLC).Methods75 patients had complete tumor resection and received the diagnosis of stageⅢa NSCLC from Jan,2005 to March,2006.Clinical significance including gender(55 male and 20 female),age(26-77,median age:59),TNM stage(T1N2M0:6, T2N2M0:52,T3N1M0:12,T3N2M0:5),histology(squamous cell carcinoma:34, adenocarcinoma:36,adeno -squamous Carcinoma:5) were retrospectively reviewed. Tumor samples were constructed by TMA and IHC to analyze the relationship between the expression of E-Cadherin,β-catenin,vimentin and fibronectin and the patients' disease-free survival(DFS) and over-all survival(OS).ResultsThe number of trace,low,intermediate,and high-level expression of E-Cadherin andβ-catenin was18,23,26,8,and 27,26,19,3 respectively.The number of positive and negative expression of Vimentin was 12 and 63.The number of negative,low, intermediate and high-level expression of fibronectin was 17,42,12 and4.There was a positive correlation between E-Cadherin andβ-catenin expression(p＜0.01) and negative correlation between E-Cadherin and Vimentin(p=0.037).Dedifferentiation was associated with reduced expression of both E-Cadherin andβ-catenin(p=0.001).24 cases(32%) survived after 3 years' follow-up.Median survival was 17.83 months.The number of disease-free survival case was 16(21.33%).14 cases(18.67%) had recurrence,45 cases(60%) had metastasis(brain:18,bone:10,liver:2,lung: 9,distal lymph node:6).In univariate survival analysis,expression of E-Cadherin,β-catenin,vimentin and fibronectin were of prognostic value in 3-year disease-free survival(DFS)(p=0.006,p=0.038,p=0.026,p=0.039).Expression of E-Cadherin andβ-catenin were of prognostic value in 3-year overall survival(OS)(p=0.001,p=0.023). In multivariate analysis,E-Cadherin and fibronectin expression was an independent prognostic factor for 3-year DFS(p=0.011,p=0.022).The expression of E-Cadherin was an independent prognostic factor for 3-year OS(p=0.028).Conclusions1.The reduced expression of E-Cadherin,β-catenin and positive expression of vimentin,fibronectin indicate shorter survival and disease-free survival.2.E-Cadherin and fibronectin expression are the independent prognostic factors for stageⅢa NSCLCs 3- year disease-free survival.3.E-Cadherin expression is the independent prognostic factors for stageⅢa NSCLCs 3-year overall survival.4.The correlation of E-Cadherin and vimentin expression is negtive.5.Reduced expression of E-Cadherin andβ-catenin correlates with poor differentiation.Novelty1.For the first time,we investigated the expression of epithelial and mesenchymal vital proteins inⅢa NSCLCs by TMA and IHC.2.Both disease -free survival and over-all survival were used to demonstrate the patients' post-operative survival.The follow-up was based on a large cohort.