GPNMB与非小细胞肺癌患者肿瘤免疫浸润和预后的相关性

doi:10.3969/j.issn.1673-8640.2023.04.009

摘要/Abstract

摘要：

目的探讨糖蛋白非转移性黑色素瘤蛋白B（GPNMB）表达在非小细胞肺癌（NSCLC）中的临床意义。方法选取2016年4月—2018年4月唐山市人民医院NSCLC患者124例。收集所有患者的癌组织和癌旁组织（距离肿瘤边缘2~3 cm）样本，采用免疫组化法检测癌组织和癌旁组织CPNMB表达水平，同时检测癌组织样本中CD44、CD206、F4/80的表达情况，依据3项指标的表达情况将所有患者分为高免疫浸润组和低免疫浸润组。收集所有患者的临床病理资料。对所有患者进行随访，随访时间为4.5~36.0个月。采用Kaplan-Meier生存曲线和Log-rank χ²检验评估NSCLC患者的生存情况。结果与癌旁组织比较，癌组织GPNMB表达显著上调（P<0.001）。不同TNM分期的NSCLC患者之间GPNMB表达差异有统计学意义（P<0.001），不同年龄、性别和组织分型的NSCLC患者之间GPNMB表达差异均无统计学意义（P>0.05）。高免疫浸润组GPNMB高表达的比例显著高于低免疫浸润组（P<0.001）。Kaplan-Meier生存曲线分析结果显示，GPNMB高表达组、中表达组、低表达组总生存期（OS）和无进展生存期（PFS）逐渐延长，各组间差异均有统计学意义（P<0.05）。结论 NSCLC患者GPNMB呈高表达，且与肿瘤免疫浸润程度和预后不良有关。

关键词: 糖蛋白非转移性黑色素瘤蛋白B, 非小细胞肺癌, 肿瘤免疫浸润, 预后

Abstract:

Objective To investigate the clinical significance of glycoprotein non-metastatic melanoma protein B（GPNMB） expression in non-small cell lung cancer（NSCLC）. Methods Totally，124 patients with NSCLC were enrolled from Tangshan People's Hospital from April 2016 to April 2018，and the patients' cancer tissue and adjacent tissue（2-3 cm from the edge of tumor） samples were collected. The expression level of GPNMB in the patients' cancer and adjacent tissues was determined by immunohistochemistry. The expressions of CD44，CD206 and F4/80 in cancer tissue samples were determined，and the patients were classified into high and low immunoinfiltration groups. The clinicopathologic data of all the patients were collected，and all the patients were followed up for 4.5 to 36.0 months. Kaplan-Meier survival curve analysis and Log-rank χ² test were used to evaluate NSCLC patients' survival. Results Compared to adjacent tissues，the expression level of GPNMB in cancer tissues of NSCLC patients was up-regulated（P<0.001）. There was statistical significance in GPNMB expression among NSCLC patients with different TNM stages（P<0.001），and there was no statistical significance in GPNMB expression among NSCLC patients with different ages，sex and tissue types （P>0.05）. The proportion of GPNMB high expression in high immunoinfiltration group was higher than that in low immunoinfiltration group（P<0.001）. Kaplan-Meier survival curve analysis showed that the overall survival（OS） time and progression-free survival（PFS） time of high，medium and low GPNMB expression groups were gradually prolonged（P<0.05）. Conclusions GPNMB is highly expressed in cancer tissues of NSCLC patients，and the up-regulation of its expression level is related to the degree of tumor immunoinfiltration and poor prognosis.

Key words: Glycoprotein non-metastatic melanoma protein B, Non-small cell lung cancer, Tumor immunoinfiltration, Prognosis

中图分类号:

R446.1

宋世伟, 李景武, 林韬, 刘泽宇, 王志强, 孙卫东. GPNMB与非小细胞肺癌患者肿瘤免疫浸润和预后的相关性[J]. 检验医学, 2023, 38(4): 347-351.

SONG Shiwei, LI Jingwu, LIN Tao, LIU Zeyu, WANG Zhiqiang, SUN Weidong. Relationship between GPNMB and non-small cell lung cancer immune infiltration and prognosis[J]. Laboratory Medicine, 2023, 38(4): 347-351.

图/表 4

图1 NSCLC患者癌旁组织和癌组织中GPNMB表达的免疫组化图注：（a）癌旁组织GPNMB低表达；（b）癌旁组织GPNMB中表达；（c）癌旁组织GPNMB高表达；（d）癌组织GPNMB低表达；（e）癌组织GPNMB中表达；（f）癌组织GPNMB高表达。

表1 GPNMB表达和患者临床病理特征的关系

组别	例数	性别		年龄/岁	组织分型			TNM分期
组别	例数	男/例	女/例	年龄/岁	肺腺癌/例	肺鳞癌/例	其他分型/例	Ⅰ期/例	Ⅱ期/例	Ⅲ期/例	Ⅳ期/例
低表达组	21	10	11	55.83±14.11	11	6	4	14	5	1	1
中表达组	37	19	18	50.42±16.48	21	9	7	6	15	13	3
高表达组	66	33	33	51.57±18.49	36	17	13	3	17	36	10
统计值		0.075		0.692	0.151			47.484
P值		0.963^①		0.503	0.997^①			<0.001^①

图2 不同肿瘤免疫浸润水平NSCLC患者癌组织免疫组化图注：（a）CD44+免疫细胞低浸润；（b）F4/80+免疫细胞低浸润；（c）CD206+免疫细胞低浸润；（d）CD44+免疫细胞高浸润；（e）F4/80+免疫细胞高浸润；（f）CD206+免疫细胞高浸润。

图3 GPNMB高表达组、中表达组和低表达组的Kaplan-Meier生存曲线注：（a）OS；（b）PFS；低表达组；中表达组；高表达组；低表达组-检剔；中表达组-检剔；高表达组-检剔。

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