The Impact Of TTF-1and SPA Expression And Different Treatments On The Prognosis Of Postoperative Lung Adenocarcinoma

ObjectiveA retropspective analysis of tissue samples of primary lung adenocarcinoma was performed to investigate the value of thyroid transcription factor-1and surfactant protein-A in the prediction of recurrence rate of postoperation, as well as the influence of treatment to the survival after recurrence. Therefore, it can predict the prognosis of postoperative lung adenocarcinoma and the clinical effects of anticarcinogen on the basis of this study.MethodsA total of260lung adenocarcinoma patients with radical Operation from September2008to August2011in the First Affiliated Hospital, College of Medicine, Zhejiang University were analyzed. Among these cases, the test of TTF-1or SPA clinical and pathological data including sex/age/Regional lymph node metastasis/Tumor size/TNM staging/differentiation degree must be available. The recurrence and following treatment was reported by telephones visits, afterwards we evaluates the various factors on the prediction value of recurrence rate of postoperation,and the survival time.Results1. Positive immunostaining with TTF-1and SPA of lung adenocarcinoma had a significant positive correlation. The positive rate of SPA expression was higher in high differentiation specimens.2. The2-year recurrence rate of postoperative lung adenocarcinoma patients were positively correlated with TNM staging and degree of differentiation, while had negative correlation with SPA expression. They were independent factors predicting the recurrence rate of postoperative lung adenocarcinoma.3. the mean survival time among different treatment groups is different:Sequential treatment group with chemotherapy and EGFR-TKIs>Chemotherapy group>Simple surgery group(26m>22m>12m).There was no statistically significant difference between chemotherapy group and sequential treatment group. Patient with high-differentiation, lower than65, sequential treatment with chemotherapy and EGFR-TKIs had longer survival benefit. And they were identified as independent survival predictors. The patients with positive SPA and TTF-1had a longer survival time(P>0.05). In the sequential treatment group with chemotherapy and EGFR-TKIs, TTF-1positive expression was an independent prognostic protection factor for lung adenocarcinoma patients.4. High-differentiation,sequential treatment group with chemotherapy and EGFR-TKIs and SPA positive expression were independent prediective factors of survival for stage II lung adenocarcinoma patients of postoperative recurrence.Conclusion1. Positive immunostaining with TTF-1and SPA had a significant positive correlation. The positive rate of SPA expression was higher in high differentiation specimens.2.Patients with positive SPA expression suffered lower postoperative recurrence in lung adenocarcinomas within2years.3. Postoperative recurrence patients treated sequentialy with chemotherapy and EGFR-TKIs had a longer survival time, suggesting the improvment of detection of EGFR mutations gene for treatment.4. The positive expression of TTF-1and SPA in lung adenocarcinoma might predict the better clinical effects of EGFR-TKIs.