| Lung cancer is the most common tumor of the human. In the recent 50 years, the morbidity and mortality of the lung cancer is advanced obviously. According to statistics, morbidity of the lung cancer occupys the first place among various kinds of malignant tumor in men in both some of western and chinese big citys. In the recent 30 years, the diagnosis and therapy of the tumor are improved rapidly. But the survival rate of the lung cancer is not raised obviously. At present, diagnosing the metastasis of the lung cancer is mainly depended on imageology (such as X-ray, CT, MRI, ultrasound, bone scan) and common pathologic examination. Common imageologic method can only find out nodes whose diameter is bigger than 1 centimeter (which is about 1 gram or contains 109 cancer cells), but can not find out the cancer cells in cycling blood and micrometastasis in bone marrow, lymphonodes and organs beside lung. These micrometastases and cancer cells in cycling blood is the main reason of metastasias and recurrrence of the tumor. According to the prognositic results of radical correction of stage I NSCLC, 25% of the patients are died by recurrence and metastasis within 5 years after operation. This shows that micrometastasis may be present at the same time when we diagnosis primatumor. Detecting micrometastasis of the lung cancer is very important to diagnosis,staging,recurrence,prognosis and selecting treatment plan of the lung cancer.Formation and development of lung cancer is caused by multiple factors. Recently, with the development of tumor biology and molecular biology , many factors are finded out which are related to prognosis of the tumor, such as P53 anti-oncogene,nm23 gene,CKs protein and PCNA, these biologic markers are very importment to lung cancer's prognosis and also combined tumor's therapy. Cell sueface adhesion molecule - CD44 - is the most valuable one in early diagnosis,progression of the disease,potency of metastasis and estimate of prognosis of the tumor.Research indicates that the expression of CD44 is earlier than ras and p53. CD44 is excessive expressed in lung cancer patients whose lymphonodes is metastasized. If CD44 protein is positive in postoperation tumor tissue, recurrence and metastasis after operation often comes easily. The relationship between CD44 protein and metastasis and prognosis of the lung cancer is under researching, and not formed a unified viewpoint yet.This experiment used RT-PCR method to detect expression of CD44 gene in NSCLC whith were got from postoperation freezing tissue samples and normal lung freezing tissue samples We analyze relationship between expresssion of CD44 and metastasis lymphonode of lung cancer. We followed up 36 cases of NSCLC and try to find out the valuation of CD44 among clinical diagnosis,therapy and prognosis of the NSCLC.Expression of CD44 gene: in the 10 cases negative control group,CD44 gene were expressed in agarose gel eletrophoresis after RT-PCR amplification. At the same condition, CD44 gene were excessive expressed in 21 cases among 36 lung cancer cases. The rate of excessive expression is 58.3%. The length of CD44 gene fragment after PCR amplification is about 500~600 bp.Relationship between expression of CD44 mRNA and clinical feature: Excessive expression of CD44 mRNA in NSCLC tissue is not related to patient's age,sex,histologic type,pathologic grade and size of tumor , but related to metastasis of lymphonodes (P<0.05).Mono-factor ANOVA of prognosis of NSCLC: Mono-factor analysis of variance of prognosis of NSCLC patients showes that prognosis of NSCLC patients related to excessive expression of CD44,pathologic grade,TNM stage,metastasis of lymphonode, but not related to age,sex,histologic type and size of tumor of the patient.Relationship between excessive expression of CD44 and survivorship: We followed up 36 cases of postoperation NSCLC patients who were not received radiotherapy and chemotherapy. Kaplan-Meier survival curve showes that survival rate of CD44 excessive expressed ones is lower than normal expressed ones in 36 cases of NSCLC(P<0.05).Metastasis and recurrence of the tumor are the main reasons that cause cancer patients die.Relationship between CD44 and invasion,metastasis and prognosis of tumor is a new topic in the past few years.This is a latest research and most of research detect CD44 gene as one kind of new molecule marker, detecting CD44 gene and its protein may help us to predict potentcy of metastasis and judge prognosis.Lots of researches confirmed that CD44v gives ability of invasion and metastasis to the tumor cells.Anti-CD44 monocolonal antibody can be used in tumor's therapy.Anti-CD44 monocolonal antibody, A3D8, can inhibit the proliferation of leukaemia HL-60 cell and change the disposition of generation cycle of HL-60. It can induce HL-60 cell block at the G0/ G1 phase, decrease caryocinesia, inhibit cell proliferation.Which kind of hypotype of CD44 abnormal expression can guides progesis and life span of NSCLC patients? Does the excessive expression of CD44 has relationship with sensitivity of radiotherapy and chemotherapy of NSCLC patients? These are the questions we need to study and research.In a word, it is clearly that CD44 is one of molecular markers to early diagnose and judge prognosis. With the development of molecular biology and deeply study of oncogene, CD44 can provide theory evidence to diagnosis,therapy,prognosis of the malignant tumor and open up a new biologic therapy way to malignant tumor metastasis.
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