Abstract
Objective We used prognosis-related genes of non-small cell lung cancer (NSCLC) to re-stage the N2 stage NSCLC and further guided the individualized treatment of N2 lung cancer that can be proposed for different therapeutic strategies.Methods We collect 96 patients with N2 lung cancer paraffin specimens,using two-step EnVision immunohistochemical to detect the expression of mucin 4 (MUC4) and insulin-like growth factor-2 (IGF-2) in these tissues.We analysis the correlation between the expression of MUC4 and IGF-2 and clinicopathological parameters,lymph node metastasis,prognosis.Results In different clinical and pathological parameters,MUC4 expression did not reached significant difference in different gender,age,smoking status,tumor location,general location,pathology,tumor size and T stage of lung cancer.For mediastinal lymph node metastasis,MUC4 in different lymph node stations,number of lymph node metastasis,subcarinal lymph node metastasis,regional lymph node metastasis and clinical (pathological) N2 of the cancer,showed differential expression (P ＜0.05) ; In high expression of MUC4 group,the median DFS was 35 months and 5 years disease-free survival rate reached 25.3％,far better than the low expression group(P ＜0.01).The high expression of IGF-2 total of 53 patients,median survival period was 19 months,and 5-year survival rate only 15.1％,significantly lower than the low expression group (P ＜ 0.01).Spearman rank correlation analysis showed that:in N2 lung cancer tissues,MUC4 and IGF-2 expression was negatively correlated (r =-0.226,P ＜ 0.05).Combined with MUC4 and IGF-2 on the Ⅲ A-N2 lung cancer molecular staging,in which MUC4+ + IGF-2-group,the best prognosis,with 5-year survival rate was 49.7 ％ (P ＜ 0.O1).Conclusion United MUC4 and IGF-2 is divided N2 non-small cell lung cancer into different subgroups.MUC4+ + IGF-2-group have the best prognosis,and completely resection is the better choice for them.For the subgroups with poor prognosis,resection is not advocated,but the choice of chemoradiotherapy is much better. Key words: Cancer,Non-small-cell lung; Mediastinal lymph node; Insulin-like growth factor-2; Prognosis
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