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Purpose: Lung cancer is the world's most common malignancy, 2002 new cases of lung cancer worldwide about 1,350,000, approximately 1.18 million deaths, including non-small cell lung cancer (non-small cell lung cancer, NSCLC) accounts for about lung cancer patients 80% of total. With the progress of industrialization, the incidence of lung cancer increased year by year, the majority of patients with lung cancer when treatment is advanced, unresectable, more than half of lung cancer patients during treatment need to receive chemoradiotherapy comprehensive treatment. Although the clinical implementation of standardized treatment, but the five-year survival rate is still only about 15%. Therefore, how to improve the sensitivity of lung cancer on chemotherapy, reducing local recurrence and distant metastasis and improve survival of patients is clinically urgent problem. With the development of molecular biology, human beings come to realize that the incidence of lung cancer development is a multi-gene regulation occurs multi-stage process. Studies have shown that tumor hypoxia and the presence of cells produced tumors resistant to chemotherapy increased tumor more aggressive, more susceptible to metastasis. Heat shock protein 90 (heat shock protein 90, HSP90) and hypoxia inducible factor 1α (hypoxia inducible factor-1α, HIF-1α) were highly expressed in a variety of human tumors. HSP90, HIF-1α and other hypoxia-responsive genes to the tumor survival, proliferation, metastasis, and tumor immunity, multi-drug resistance and prognosis of cancer patients on conventional treatment, including radiation and chemotherapy drug resistance. This experiment studies HSP90α in non-small cell lung carcinoma and its relationship with prognosis, HSP90α and further explore the relationship between HIF-1α, using immunohistochemistry (immunohi-stochemistry, IHC) SP method detected 50 cases accepted simply put comprehensive treatment of patients with NSCLC cancer wax blocks HSP90α and HIF-1α protein expression to explore the relationship between the two and its relationship with clinicopathological features of the relationship, and then observe HSP90α with NSCLC prognosis for NSCLC gene therapy new strategy to explore new targets to provide theoretical and experimental basis, non-small cell lung cancer treatment (especially individualized treatment) provide more adequate theoretical basis and new strategies and approaches. Methods: a research institute with a specimen taken from November 2007 to October 2010 in Hebei Province People's Hospital Oncology treated with clear histological pathological diagnosis, non-surgical treatment of non-small cell lung cancer 50 cases, the patients were by fiberoptic bronchoscopy or percutaneous lung puncture pathology. TNM clinical stage using AJCC / UICC staging system, stage 0 cases where I, II in 10 cases, III 20 cases, IV of 20 cases. Patients were divided into early group (I-II period, 10 cases) and in the late group (III-IV stage, 40 cases). 2 immunohistochemistry (SP method), detected 50 cases of lung cancer wax blocks HSP90α and HIF-1α protein expression in lung cancer patients with clinical pathological factors, analyze the relationship between the two and their relationship with the prognosis of NSCLC. 3 using SPSS13.0 statistical software package for analysis and processing. Count data using χ2 test, with P lt; 0.05 was considered statistically significant; application Kaplan-Meier survival analysis, Log-rank for survival comparisons to test the level α = 0.05; using Cox proportional hazards regression model Multivariate analysis to P lt; 0.05 was considered statistically significant. Results: 1 HSP90α in non-small cell lung carcinoma cases HSP90α in non-small cell lung cancer positive expression mainly in the cytoplasm, a few located in the nucleus, brownish yellow granular, diffuse punctate distribution, the total positive expression was 78% (39/50). Correlation test found, HSP90α were correlated with clinical TNM stage and lymph node metastasis were positively correlated, χ2 test showed a significant difference (P lt; 0.05). HSP90α in the middle and late (III-IV) NSCLC tissues, the positive expression rate was 87.5% (35/40), significantly higher than in the early (I-II) NSCLC tissues and 40% (4/10); HSP90α where positive lymph node metastasis group was 87.8% (36/41), in the absence of lymph node metastasis group expression was 33.3% (3/9). HSP90α protein expression and patient gender, age, tumor location, tumor size, histological type and degree of differentiation was no significant difference (P gt; 0.05). 2 HIF-lα in non-small cell lung carcinoma cases HIF-lα in non-small cell lung cancer cell expression mainly in small cell nucleus, brownish yellow, diffuse or spotty distribution, the total positive rate 62% (31/50). Correlation test found, HIF-lα were correlated with clinical TNM stage and lymph node metastasis were positively correlated, χ2 test showed a significant difference (P lt; 0.05), HIF-lα in III-IV NSCLC, positive expression rate 72.5% (29/40), significantly higher than stage I-II lung cancer group, 20% (2/10); HIF-lα expression in lymph node metastasis rate was 70.7% (29/41), in the absence of lymph node metastasis in NSCLC The positive expression rate of 22.2% (2/9). HIF-lα protein expression and patient gender, age, tumor location, tumor size, histological type and degree of differentiation was no significant difference (P gt; 0.05). 3 HSP90α and HIF-1α expression in NSCLC tissues correlation HSP90α and HIF-1α protein in NSCLC tissues were expressed in the number of cases was 30 cases, correlation tests have shown that the two proteins were positively correlated (Pearson column connection number C = 0.501, P = 0.000). 30 patients, 28 cases were advanced, including 11 cases of stage III, IV of 17 cases. 4 NSCLC survival after chemotherapy treatment of 50 cases of NSCLC patients after 3-year survival rates were 42.9%, 18.8%, 8%, with a median survival of 11.0 months, the median survival of 15.4 months; HSP90α protein positive and negative groups after chemotherapy 1,2,3 year survival rates were 71.8%, 34.2%, 3.1% and 76.2%, 45.7%, 30.5%, Log-Rank test showed differences between the two groups was significant survival curves difference (P = 0.009); HIF-1α protein expression positive and negative groups after chemotherapy 1,2,3 year survival rates were 64.2%, 7.7%, 3.9%, and 64.7%, 40.4%, 16.2%, Log-Rank test shows two survival curves were significantly different (P = 0.015). 5 NSCLC prognostic factor analysis Univariate analysis showed that: lymph node metastasis, clinical stage, HSP90α and HIF-1α in non-small cell lung cancer after chemotherapy and prognosis are related (P lt; 0.05); patient sex, age, tumor location, pathological type and degree of tumor differentiation in non-small cell lung cancer had no significant effect (P gt; 0.05). Cox regression multivariate analysis showed that TNM clinical stage (B = 1.925, P = 0.002) and HIF-1α (B = 0.834, P = 0.030) as independent prognostic risk factor for NSCLC. Conclusions: 1 NSCLC tissues HSP90α and HIF-1α protein were highly expressed; HSP90α, HIF-1α protein expression were associated with NSCLC, TNM stage, lymph node metastasis, suggesting that the later clinical stage, both positive expression is higher. 2 HSP90α and HIF-1α expression positively correlated. 3 HSP90α and HIF-1α protein positive survival rate was significantly lower than the negative group. 4 lymph node metastasis, clinical stage, HSP90α and HIF-1α protein expression and prognosis in NSCLC are relevant; clinical TNM stage and HIF-1α is an independent risk factor for NSCLC prognosis.
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