| Objective:In this study,we aimed to assess the expression of TTF-1,Ki67 and P53 to predict the extent of malignant tumor and prognostic value in patients with non-small cell lung cancer,by analyzing the correlation between the expressions of TTF-1,Ki67 and P53 and the clinicopathological features of the patients with non-small cell lung cancer.Methods: The study retrospectively investigated patients with non-small cell lung cancer who underwent surgery of lung cancer in our hospital in January 2007 to December 2008.The clinical pathological features,including pathological type,sex,age,smoking history,lung cancer differentiation,lymph node metastasis or not,postoperative life time was collected,and the expression of TTF-1,Ki67 and P53 in pathological specimens was detected by immunohistochemistry.Then the relationship between the expression of TTF-1,Ki67,P53 and the clinicopathological features of the patients with non-small cell lung cancer were analyzed respectively.Results :Among the 72 patients with non-small cell lung cancer,32 cases were lung adenocarcinoma,38 cases were squamous cell lung cancer,and 2 cases were lung adenocarcinoma.Among them,50 males and 22 females.All the patients were aged between 38 and 78,with an average age of 59.5 years,29 persons were less than 60 years old and 43 persons were more than 60 years old.In this group,smoking was the same as non-smoking patients(51.39% vs.48.61%),37 and 35 respectively.No lymph node metastasis was observed in 42 patients,and lymph node metastasis occurred in 30 patients.There were 11 patients with well-differentiated,35 of whom were moderate tumor differentiation,and 26 with poor tumor differentiation.The postoperative survival time of 37 patients was <5 years,the shortest was the death within 1 year after the operation,and the survival time of 35 patients was greater than 5 years,and the longest follow-up period was 8 years.In different types of non-small cell lung cancer pathology,the expression of TTF-1 in lung adenocarcinoma is higher than that of squamous cell lung cancer,and Ki67 expressed in squamous cell lung cancer is higher than the lung adenocarcinoma,which were statistically significant.However,the differences in expression of P53 in different pathological types were not statistically significant.The expression of TTF-1 in adenocarcinoma lung cancer was 81.3%,compared with 26.3% in squamous cell lung cancer,χ2=20.986,p<0.001.While the expression of Ki67 in the squamous cell lung cancer was 92.1%,and 62.5% in the adenocarcinoma,χ2=9.043,p=0.003.The positive expression of Ki67 in male patients was higher than that of female patients,and the difference was statistically significant,while TTF-1 and P53 had no statistically significant difference in genders.The rate of expression of Ki67 in male non-small cell lung cancer patients were 86.0%,compared with 59.1% in female patients.There was no statistically significant difference in the expression of TTF-1,Ki67 and P53 in different age groups(age <60 years group and > 60 years).The expression TTF-1 in the non-smoking patients were higher than that in the smoking group,and the difference was statistically significant,but Ki67 and P53 were not.The rate of expression of TTF-1 in non-smoking patients were 71.4%,compared with 35.1% in the smoking group.The results of Spearman rank correlation coefficient test statistical analysis suggested,the expression of TTF-1 and P53 was closely related to the degree of tumor differentiation,while the expression of Ki67 was not.The results indicated the expression of TTF-1 was negatively correlated with tumor differentiation.Contrarily,that of P53 positively correlated with tumor differentiation.The expression of P53 in lung cancer patients with lymphatic metastasis was different from the non-lymph node metastasis patients.However,there was no statistically significant difference in the expression of TTF-1 and Ki67 whether there was presence of lymph node metastasis in nonsmall cell lung cancer patients or not.The high expression rate of P53 in the lymph node metastasis group was 50.00%,while in the non-lymph node metastasis group was 26.19%,and the difference was statistically significant.The results of Kaplan Meier method showed that,the high expression of TTF-1 had a better postoperative survival time than low expression group.The difference survival curve distribution of low expression of TTF-1 between the high expression group was statistically significant,the log rank test statistic χ2 = 4.786,p = 0.029.The postoperative survival time of high expression of P53 patient was shorter than the low expression group,the log rank test statistic χ2 = 12.952,p < 0.001.However,there was no statistically significant in the difference survival curve distribution of low expression of Ki67 and that of the high expression group.Conclusion: TTF-1,Ki67 were valuable indicators for the identification of pathologic types of non-small cell lung cancer.The expression of TTF-1 in lung adenocarcinoma is significantly higher than that of squamous cell lung cancer,but the expression of Ki67 had a contrary result.The expression of TTF-1and P53 was closely related to the malignancy of non-small cell lung cancer,which can be used as important indicators for predicting the prognosis of patients with non-small cell lung cancer.The expression of TTF-1 was negatively correlated with the malignancy of nonsmall cell lung cancer.A higher the expression of TTF-1 predicted a lower the malignancy of nonsmall cell lung cancer,and the better the prognosis.While the expression of P53 was positively correlated with the malignancy of non-small cell lung cancer.A higher the expression of p53 predicted a higher the malignancy of non-small cell lung cancer,and the worse the prognosis. |
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