Expression And Clinical Significance Of TTF-1and Ki67in Non-small Cell Lung Cancer

BackgroundLung cancer is first leading cause of the incidence and cancer-related death in the world. Non-small cell lung cancer (NSCLC) accounts for approximately80%of these cases. The standard treatment is two agents combination schemes including the platinum drugs, but its efficient is only20%～35%or so. Along with the recognation of its genotype, people realize that different tumor have different gene phenotypes, protein expression patterns and biology behavior.ObjectivesTo study the expression alterations of Thyroid Transcription Factor1(TTF-1) and Ki-67in NSCLC, and explore their clinical significance for diagnosis, treatment and evaluation of prognosis of NSCLC.MethodsOne hundred and thirty four primary NSCLC tissue specimens and their related clinical pathology materials from the second affiliated hospital of Zhengzhou University between January2007and December2010were collected. The expressions of TTF-1and Ki67were detected by immunohistochemical staining. The data were analysised by statistical package SPSS17.0.Results 1. TTF-1was expressed positively in [80.9%(55/68)] of lung adenocarcinoma, higher than that in squamous carcinoma[7.0%(4/57)],(P=0.001). There was no statistical significance for the expression of Ki67among pulmonary squamous carcinoma, adenocarcinoma and adenosquamouscarcinoma(P=0.063).2. TTF-1was significantly upregulated (p<0.05) in patients of female, with high grade cellular differentiation, tumor size less than3cm and stage Ⅰ and Ⅱ. The expression of K-i67was related to smoking, the grade of cellular differentiation and the metastasis of lymph node(p<0.05).3. Logistic regression analysis showed that histological classification, cell differentiation and size of primary tumor were the factors related to expression of TTF-1(p<0.01); the factors related to expression of K-i67were the grade of cellular differentiation and the metastasis of lymph node (P<0.01).4. There was no significant relevance between the expression of TTF-1and Ki-67(r=0.115,P=0.188).5. Statistical analysis showed that the survival time of NSCLS with TTF-1positive was superior to that with TTF-1negativ e(p=0.001). Both of median survival time was31and14months, and the survival time of NSCLS with Ki-67positive were shorter than that with Ki67negative(p=0.014). Both of median survival time were18and26months,survival curves were statistically significant difference.6. TTF-1, Ki-67, the size of primary tumor and TNM stage were independent factors affecting the NSCLC (P<0.01).Conclusions1. The expression of TTF-1is high in pulmonary adenocarcinoma, which could be a valuable index in the diagnosis of pulmonary adenocarcinoma.2. The poor cell differentiation, bigger tumor volume, higher TNM stage and lower positive expression rate of TTF-1, are negative factors for survival time in NSCLC. The clinical course is more aggressive and the outcome is worse for those with lower expression of TTF-1.3. The higher expression of Ki67may be indicator of the malignant transformation of lung cell, infiltration of tumor, metastasis and shorter survival time. 4. It’s possible that TTF-1and Ki-67could provide valuable reference for judging lung cancer biology behavior and predict the prognosis of patients with NSCLC.