Analysis Of Prognostic Factors In Non-small Cell Lung Cancer

Objective:To analyze the prognostic factors for 182 cases of non-small cell lung cancer. To discuss the expression and clinical significance of GST-π,HIF-1 a and G-CSF in non-small cell lung cancer.Methods:182 patients with non-small cell lung cancer treated in the First Affiliated Hospital of Zhengzhou University from Januany 2007 to Januany 2008 were enrolled. The influence of operation, chemotherapy, radiotherapy, platelet count, the level of gamma-glutamyltranspetidase, hemoglobin level, white blood cell count and TNM stage on the prognosis of patients with non-small cell lung cancer was analyzed. Survival analysis was evaluated through Kaplan-Meier and Log-rank tests, and multivariate analysis was preformed using COX proportional hazards regression model.There are 57 surgical cases and 45 cases with well preserved paraffin blocks, for the 182 patients with complete follow- up data in non-small cell lung cancer. SP immunohistochemistry was used to detect the expression of GST-π, HIF-1αand G-CSF in 45 cases of non-small cell lung cancer tissues.The relationship of their positive expression to the prognosis of non-small cell lung cancer patients was analyzed.Results:The overall 1-,2-,3-year survival rate is 62.1%,35.2%,25.5%, respectively. The median survival time is 16 months. It is found through univariate analysis that operation, the level of gamma- glutamyltranspetidase, hemoglobin level, white blood cell count and TNM stage can affect the survival of patients, (x2=22.08,16.584, 5.956,5.921, and 7.049, P<0.05). It is also found through multivariate analysis that operation, the level of gamma- glutamyltranspetidase, hemoglobin level and TNM stage are the independent survival factors, (RR=0.381,1.883,2.010 and 0.006,95% CI为0.251～0.581,1.173～3.022,1.285～3.144 and 1.281～3.127).The 3-year survival rate and the median survival for the group of 45 patients is 46.7% and 29 months respectively. GST-π, HIF-la and G-CSF three caught are expressed mainly in cytoplasm in tumor cell of non-small cell lung cancer. The positive expression of GST-π, HIF-la and G-CSF separately are 48.9%,26.7% and 68.9%. The expression of G-CSF in different pathological types are significantly different, and the positive expression is higher in adenocarcinoma than other types (p <0.05). Multivariate analysis show that:TNM stage and the expression of GST-πare the independent prognostic factors (p<0.05). The expression of GST-πhas obviously positive correlation with G-CSF in non-small cell lung cancer, (r=0.369, P=0.013).Conclusion:The important factors are operation, the level of gamma-glutamyltranspetidase, hemoglobin level, white blood cell count and TNM stage, which can affect the prognosis of patients with non-small cell lung cancer.GST-πis the independent prognostic factors in NSCLC, the same as the TNM stage, and the larger number of positive cells indcating poor prognosis.