Prognostic significance of nestin expression in patients with resected non-small cell lung cancer treated with platinum-based adjuvant chemotherapy; relationship between nestin expression and epithelial to mesenchymal transition related markers.
Prognostic significance of nestin expression in patients with resected non-small cell lung cancer treated with platinum-based adjuvant chemotherapy; relationship between nestin expression and epithelial to mesenchymal transition related markers.
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DOI：
10.1371/journal.pone.0173886
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Masuda N
中科院分区：
文献类型：
--
作者：
Ryuge S;Sato Y;Nagashio R;Hiyoshi Y;Katono K;Igawa S;Nakashima H;Shiomi K;Ichinoe M;Murakumo Y;Saegusa M;Satoh Y;Masuda N
虽然辅助铂基化疗（AC）已被证明可以提高完全切除的II期和IIIA期非小细胞肺癌（NSCLC）患者的生存率，但其效果有限。Nestin是一类在神经干细胞和包括NSCLC在内的几种肿瘤细胞中表达的VI类中间丝蛋白。在本研究中，我们旨在确定其对接受AC治疗的非小细胞肺癌患者生存的预后意义。我们对90例接受AC治疗的完全切除的II期和IIIA期非小细胞肺癌患者进行了免疫组织化学研究，并评估了Nestin在癌细胞中的表达及其与临床病理参数（包括ABCG2、E-cadherin和vimentin表达）的相关性。采用Kaplan-Meier生存分析和Cox比例风险模型估计nestin表达对生存的影响。90例非小细胞肺癌中有28例（31.1%）表达Nestin。临床病理上，nestin表达与E-cadherin表达缺失（P = 0.006）和vimentin阳性表达缺失（P < 0.001）相关。在生存分析中，nestin的表达与较差的预后显著相关（P = 0.028）。多变量分析证实，nestin表达是接受AC治疗的NSCLC患者的独立预后指标（HR = 2.56; 95% CI, 1.23-5.30, P = 0.01）。本研究表明，nestin表达是接受AC治疗的NSCLC患者生存率较低的预后指标，尽管其预后意义仍需要在更大的患者群体中得到证实。
Although adjuvant platinum-based chemotherapy (AC) has been shown to improve survival of patients with completely resected stage II and stage IIIA non-small cell lung cancer (NSCLC), its effect is limited. Nestin is a class VI intermediate filament protein expressed in neural stem cells and several cancer cells including NSCLC. In the present study, we aimed to determine its prognostic significance concerning survival in NSCLC patients receiving AC. Nestin expression in cancer cells was immunohistochemically studied in 90 patients with completely resected stage II and stage IIIA NSCLC treated with AC and its association with clinicopathologic parameters, including ABCG2, E-cadherin, and vimentin expression, was evaluated. Kaplan-Meier survival analysis and Cox proportional hazards models were used to estimate the effect of nestin expression on survival. Nestin expression was observed in 28 of the 90 (31.1%) NSCLCs. Clinicopathologically, nestin expression was associated with loss of E-cadherin expression (P = 0.006) and vimentin positive expression (P < 0.001). In survival analysis, nestin expression was significantly associated with a poorer prognosis (P = 0.028). Multivariable analysis confirmed that nestin expression is an independent prognostic indicator in NSCLC patients receiving AC (HR = 2.56; 95% CI, 1.23–5.30, P = 0.01). The present study reveals that nestin expression is a prognostic indicator of a poorer survival probability in NSCLC patients receiving AC, although its prognostic significance still requires confirmation with larger patient populations.