【作者】 胡风标；

【导师】 沈毅； 魏煜程；

【作者基本信息】 青岛大学 ， 胸心外科学， 2007， 硕士

【摘要】 目的探讨非小细胞肺癌CD44途径免疫逃逸的机制及其临床意义。方法采用免疫组化EnVison法，检测CD44s、CD44v6以及Fas基因蛋白在60例非小细胞肺癌组织中的表达，分析其相关性。结果1．与癌旁肺组织相比，Fas基因蛋白在非小细胞肺癌组织中的表达减弱，Fas在肺鳞癌和腺癌的表达率为62.5％和46.4％。2．CD44s和CD44v6在癌旁正常肺组织未见表达；CD44s在鳞癌和腺癌的表达率分别为83.3％和54.2％，CD44v6在鳞癌和腺癌的表达率分别为81.0％和39.6％。3．Fas、CD44s和CD44v6的表达均与肿瘤TNM分期、分化程度及淋巴结转移相关(P＜0.01)，TNM分期越晚，分化越低，有淋巴结转移时，Fas和CD44s的表达的强度越弱、阳性率越低，而CD44v6表达的强度越强、阳性率越高。结论1．非小细胞肺癌通过癌细胞表面CD44分子的构型由标准型向变异体改变(CD44s——CD44v6)，降低其Fas的表达，从而逃脱Fas-FasL介导的细胞凋亡，这可能是非小细胞肺癌存在CD44途径免疫逃逸。2非小细胞肺癌CD44s、CD44v6及Fas基因蛋白的检测可能为机体免疫状态、肿瘤进展程度及其预后的判断指标。更多还原

【Abstract】 Objective To study the mechanism of CD44 way immune escape in non-smallcell lung cancer and its clinical significance. Methods EnVison immunohistochemicalmethod was used to study the expression of Fas, CD44v6 and CD44s in 60 cases ofnon-small lung cancer and adjcent normal lung tissue. Results 1. The expression ofFas in non-small cell lung cancer (NSCIC) weaken campare with adjcent normal lungtissue, and positive expression rates are 100%, 62.5% and 46.4% in adjcent normallung tissue, squamous cell carcinomas and adenocacinomas respectively. 2. NoCD44s and CD44v6 positive expressions is seen in adjcent normal lung tissue.Positive expressions of CD44s is 83.3% and 54.2% in squamous cell carcinomas andadenocacinomas respectively, and positive expressions of CD44v6 is 81.0% and39.6% in squamous cell carcinomas and adenocacinomas respectively. 3. Expressionof Fas, CD44s and CD44v6 are correlated with NSCLC’s TNM stages, differentiationand lymphatic metastasis. Expression of Fas and CD44s weaken in late stage, lowerdifferentiation and lymphatic metastasis cases, and their positive expression decrease,however, Expression of CD44v6 is on the contrary. Conclusion 1. The mechanism ofCD44 way immune escape in NSCLC may lie in the transformation of CD44 moleculefrom standard type to variant type, variant type CD44 molecule causes the weaken of Fasexpression, so the cancer cell can escape from the apoptosis mediated by Fas-FasLsystem. 2. Detection of the expression of Fas, CD44s and CD44v6 may show immunestatus, degree of tumor’s advancement and prognosis of NSCLC.更多还原