NDRG1及nm23在喉鳞状细胞癌中的表达特点及其对喉鳞癌患者预后的影响

Expression Characteristics of NDRG1 and nm23 in Laryngeal Squamous Cell Carcinoma and Their Effects on the Patient’s Prognosis

摘要: 目的：分析N-myc下游调节基因1 (N-myc downstream regulated gene 1, NDRG1)和非转移性第23基因(non-metastatic 23rd gene, nm23)在喉鳞癌中的表达特点及其对喉鳞癌患者预后的影响。方法：利用免疫组化方法，观察喉息肉、喉乳头状瘤及喉鳞癌中NDRG1和nm23蛋白的表达特点，对25位喉鳞癌患者进行随访以了解2个因子对患者预后的影响。结果：(1) NDRG1蛋白在喉息肉中表达最弱，从喉息肉→喉乳头状瘤→喉鳞癌的表达阳性率有逐渐升高趋势，两两比较差异有显著性(P = 0.000)；高、中、低分化喉鳞癌中NDRG1表达也为逐渐升高态势，高分化与中分化、低分化鳞癌间差异有显著性(P = 0.001, 0.000)；T1~T2期喉鳞癌中NDRG1的表达阳性率高于T3~T4期喉鳞癌组织中的，淋巴结未发生转移组中NDRG1的表达阳性率高于淋巴结发生转移组，但差异均无显著性(P > 0.05)；(2) 喉息肉与喉乳头状瘤、喉鳞癌中nm23蛋白表达差异有显著性(P = 0.000)，T1~T2期喉鳞癌组织nm23蛋白表达高于T3~T4期(P = 0.000)，淋巴结未发生转移组中nm23蛋白表达明显高于淋巴结发生转移者(P = 0.004)；在高、中、低分化喉鳞癌中，nm23蛋白表达阳性率逐渐升高，但差异无统计学意义(P = 0.717)；(3) 喉鳞癌患者NDRG1蛋白表达越强，患者死亡风险越大。结论：(1) NDRG1可能与喉鳞癌的发生、病理学分级和临床分期有关；(2) nm23低表达与喉鳞癌进展有关；(3) NDRG1蛋白表达增强有可能作为预测喉鳞癌患者预后不良的指标之一。

Abstract: Objective: To analyze the expression characteristics of NDRG1 and nm23 proteins in laryngeal squamous cell carcinoma and their effects on the prognosis of laryngeal squamous cell carcinoma patients. Methods: Immunohistochemistry (IHC) and computer image analysis (IA) were used to observe the expression characteristics of NDRG1 and nm23 proteins in laryngeal polyps, laryngeal papilloma and laryngeal squamous cell carcinoma. Twenty-five patients with laryngeal squamous cell carcinoma were followed up to understand the influence of these two factors on the prognosis of the patients. Results: (1) The expression of NDRG1 protein was the weakest in laryngeal polyps. From laryngeal polyp to laryngeal papilloma to laryngeal squamous cell carcinoma, the positive rate of expression increased gradually, and there was a significant difference in comparison (P = 0.000). The expression of NDRG1 also increased gradually in high, medium and low differentiated laryngeal squamous cell carcinoma, and there was significant difference between high differentiated and medium, low differentiated squamous cell carcinoma (P = 0.001, 0.000). The expression of NDRG1 protein in T1~T2 stage laryngeal squamous cell carcinoma was higher than that in T3~T4 stage. The expression of NDRG1 protein in the group without lymph node metastasis was higher than that in the group with lymph node metastasis, but the differences were not statistically significant (P > 0.05). (2) There was significant difference in nm23 protein expression between laryngeal polyps and laryngeal papilloma, laryngeal squamous cell carcinoma (P = 0.000). The expression of nm23 protein in T1~T2 stage laryngeal squamous cell carcinoma was higher than that in T3~T4 stage (P = 0.000). The expression of nm23 protein in the group without lymph node metastasis was higher than that in the group with lymph node metastasis, and the differences were statistically significant (P = 0.004). The expression of nm23 protein in laryngeal squamous cell carcinoma with high, medium and low differentiation was gradually decreased, and the difference was not statistically significant (P > 0.05). (3) The higher expression of NDRG1 protein in patients with laryngeal squamous cell carcinoma, the greater risk of death. Conclusions: (1) The expression of NDRG1 may be related to the occurrence, pathological grade and clinical stage of laryngeal squamous cell carcinoma. (2) Low expression of nm23 is associated with the progression of laryngeal squamous cell carcinoma. (3) Enhanced expression of NDRG1 protein may be one of the poor prognostic in-dicators of laryngeal squamous cell carcinoma patients.