The Study Of Molecular Markers Difference Between The Primary Tumor And Metastasis Lymph Node In Patients With Non-small Cell Lung Cancer

【Background】Lung cancer is the highest morbidity and mortality of humanmalignant tumors Currently lung cancer has become the world including China,the main reason of death from cancer in most countries[1]. According to statistics,China has 429,000 people in 2005 died of lung cancer, And in the next centurythis number will double. Clinical manifestations of lung cancer according tocurrent and biological characteristics into two categories: small cell lung cancerSCLC and non-small cell lung cancer NSCLC. One non-small cell lung cancer isdivided into squamouscarcinoma, adenocarcinoma and large cell lung cancer andother major histological types. Non-small cell lung cancer are the main method ofsurgery, chemotherapy and radiotherapy. And individual treatment is advocated inrecent years, a new concept. By immunohistochemical methods to identify lungcancer-related molecular markers, based on test results choose sensitive drugs forpostoperative adjuvant chemotherapy, targeted, on the extension of survival ofpatients with lung cancer, the survival rate has a very important role in improving.Domestic and international research shows that LRP, RRM-1, EGFR, ERCC-1and lung cancer chemotherapy is the choice of molecular markers closely.Throughthe study of these molecular markers and evaluation of non-small cell lung cancerpatients choose effective chemotherapy drugs is of important guidingsignificance[2-5]. Of lung cancer but the effect of postoperative adjuvantchemotherapy is not satisfactory. Highly malignant tumor, the tumor tissue itself,poor sensitivity to chemotherapy and so is certainly a reasonable explanation, butthe method of choice of adjuvant chemotherapy drugs may also be an importantreason. The prevailing practice is radical surgical resection of primary tumor, onlytumor resection for the detection of objects immunohistochemical study toidentify molecular markers related to lung cancer, according to test results andthen select the chemotherapy drugs, to patients after surgery Adjuvantchemotherapy. However, after surgery, the primary lesion removed from the body,the body may be retained in the tumor metastasis to the lymph nodes, this part ofthe biological characteristics of tumor tissue with the primary lesion may bedifferent, but the main treatment for postoperative adjuvant chemotherapy The goal is the possible remaining tumor tissue in lymph nodes, if we do not studytheir biological characteristics, but only on the primary lesions were detected, willinevitably lead to targeted chemotherapy is not strong, the effect is not satisfied.At home and abroad has been observed that a number of molecular markersassociated with lung cancer [6], but almost no one on the primary tumor andmetastatic lymph nodes between the molecular biology research, systematicobservation. In fact, to identify these differences and to guide postoperativeadjuvant chemotherapy for the treatment of individual tumors is very meaningful.It is possible to change the mode of adjuvant chemotherapy after surgery andsignificantly improve the effect of adjuvant chemotherapy.【ObjectivObjective】Thisstudy observed non-small cell primary lung cancer and lymph node expressionand biological characteristics of non-small cell lung cancer andpharmacogenomics-related molecular markers, to find out the difference betweenanalysis of difference and pathology of non-small cell Adjuvant chemotherapyafter radical resection of lung cancer patients provide the basis for the choice ofdrugs.【Materials and Methods】(1) Select the thoracic surgery in our hospitalfrom September 2010 to February 2011 and after hospital treatment ofpathologically confirmed lymph node metastasis (lymph node metastasis limitedto the ipsilateral side lobe bronchus and the ipsilateral mediastinal N1 and N2 canbe full and complete surgical removal Persons) of 12 patients with NSCLC,radical surgery of lung cancer lines, while resection of the primary lesionmetastatic lymph node dissection. (2) using immunohistochemistry primarylesions were measured in lung tissue and metastatic lymph node tissues of theLRP, RRM-1, EGFR, ERCC-1 expression. (3) analysis of different pathologicaltypes of non-small cell lung cancer primary tumor tissues and metastatic lymphnode tissues of the LRP, RRM-1, EGFR, EERCC-1 difference.【Results】12patients, male 11, female 1 case. Aged 45-75 years, mean age of 55.42, standarddeviation of 8.50. Including 3 cases of adenocarcinoma, squamous cell carcinomain 7 cases, 2 cases of large cell carcinoma; poorly differentiated carcinoma in 1case, 4 cases of poorly differentiated carcinoma, undifferentiated carcinoma in 3cases, high grade carcinoma in 2 cases. Previous history of smoking in 8 cases, 4cases of non-smoking. LRP in primary lung cancer and metastatic lymph nodesare different in 3 cases, RRM-1 in primary lung cancer and metastatic lymphnodes in 7 cases there are differences, EGFR in lung cancer primary tumor andlymph node metastasis in 5 cases discrepancy, ERCC-1 In primary lung cancerand metastatic lymph nodes are different in 3 cases. The average differencebetween large cell lung cancer was 62.5%; squamous cell carcinoma was 25.0%; adenocarcinoma was 50.0%.【ConclusioConclusion】Part of the molecular markers of lungcancer in non-small cell lung cancer primary tumor and metastatic lymph nodesexpressed differently, in which the expression of RRM-1 was statisticallysignificant difference. Non-small cell lung cancer associated with differentpathological types of differential expression of molecular markers of different.Smallest difference which expression of squamous cell carcinoma,adenocarcinoma Second, large cell carcinoma, the most. According to ourresearch, we propose sensitivity in lung cancer chemotherapy drug selection,should be the primary lesion and metastatic lymph nodes were screened toidentify a common sensitive drugs. For adjuvant chemotherapy, the choice of drugsensitivity of metastatic lymph nodes should be standard.