| Objective:To investigate the impact of type 2 diabetes mellitus(T2DM)on the prognosis of NSCLC patients undergone radical surgery;To investigate the expression of IGF-1R and HIF-1α in NSCLC tissues and adjacent tissues and to analyze the relationship between the expression of IGF-1R and HIF-1α and with or without T2 DM diagnosed and prognosis;Primary discussion for the mechanism that T2 DM influences the prognosis of NSCLC patients.Methods:(1)From September 2005 to June 2012,a total of 138 NSCLC patients undergone radical surgery were selected in the Thoracic Surgery Department,China Medical University Cancer Hospital and 69 of them were diagnosed with T2 DM and the other 69 patients were without T2 DM.The two groups were 1:1 matched on gender,age,smoking,TNM stage and pathological type ensuring no differences of these factors between them.All patients had no preoperative or postoperative treatments including chemotherapy,radiotherapy or targeted therapy.Kaplan-Meier analysis were used to find out the relationships between with or without T2 DM diagnosed and the prognosis and survival of NSCLC patients.(2)107 patients with well follow-up and pathological specimen were selected from patients above.Immunohistochemistry staining(IHC)was used to analyze the differential expression of IGF-1R and HIF-1α in NSCLC tissues and adjacent tissues.The relationships between the expression of IGF-1R and HIF-1α and T2 DM diagnosed and the prognosis of NSCLC patient were analyzed with the method of univariate and multivariate analysis and Kaplan-Meier analysis.Spearman correlation analysis was employed to analyze the relationships between the expression of IGF-1R and HIF-1α and T2 DM diagnosed.Results:(1)Follow up 138 patients of the two groups(7 patients lost to follow-up including 3 patients from the group with T2 DM diagnosed and 4 patients from the group without T2 DM diagnosed,rate:5.07%),43 of 66 patients of the group with T2 DM diagnosed were dead within 5 years(65.15%)and 23 of 65 patients of the group without T2 DM diagnosed were dead within 5 years(38.04%).The 5-year-survival of two groupshave a significant statistical difference(P=0.044).Univariate and multivariate analysis revealed that T2 DM diagnosed was an independent risk factor for the prognosis of NSCLC patients undergone radical surgery.Kaplan-Meier analysis proved that patients without T2 DM diagnosed had better survival than those with T2 DM diagnosed(P<0.05).(2)Immunohistochemistry staining proved that in 107 specimens(including 54 with T2 DM diagnosed and 53 without T2 DM diagnosed),IGF-1R was highly expressed in the NSCLC tissues(60 of 107,rate:56.07%)compared with the adjacent tissues(26 of 107,rate:24.30%)and the significant statistical difference was found(P<0.05).Moreover,IGF-1R was highly expressed in the patients with T2 DM diagnosed(36 of 54,rate:66.67%)compared with the patients without T2 DM diagnosed(24 of 53,rate:45.28%)and the significant statistical difference was found(P<0.05).Univariate and multivariate analysis proved that the expression of IGF-1R was not an independent risk factor for the prognosis of NSCLC patients undergone radical surgery.Spearman correlation analysis proved that the expression of IGF-1R was positive correlation with T2 DM diagnosed(correlation coefficient:0.315,P=0.027).Kaplan-Meier analysis revealed that patients with positive IGF-1R expression had worse survival than those with negative IGF-1R diagnosed(P<0.05).(3)HIF-1α was highly expressed in the NSCLC tissues(60 of 107,rate:56.07%)compared with the non-tumor tissues(4 of 107,rate:3.74%)and the significant statistical difference was found(P<0.05).Moreover,HIF-1α was equally expressed in the patients with T2 DM diagnosed(29 of 54,rate:53.70%)compared with the patients without T2 DM diagnosed(31 of 53,rate:58.49%)and no significant statistical difference between them.Univariate and multivariate analysis proved that the expression of HIF-1α was an independent risk factor for the prognosis of NSCLC patients undergone radical surgery.Conclusion:(1)T2DM diagnosed,the expression of IGF-1R and HIF-1α correlate with the overall survival time in NSCLC patients undergone radical surgery.(2)IGF-1R and HIF-1α are positively expressed in NSCLC tissues and correlates with the5-year-survival of the patients,while,the expression of IGF-1R correlates with the T2 DM diagnosed.(3)T2DM diagnosed and the expression of HIF-1α are both independent risk factors of the prognosis for NSCLC patients undergone radicalsurgery.(4)The expression of IGF-1R was positive correlation with T2 DM diagnosed. |
PDF Full Text Request