Correlation Between Shh Protein Expression and Clinical Features and Prognosis of Lung Adenocarcinoma
Objective To analyze the expression of Sonic Hedgehog(Shh)protein in lung tissues and its association with the clinicopathologic features and prognosis of lung adenocarcinoma patients.Methods The basic information,resected lung tissue samples and tumor pathological data of 235 patients who had undergone lung adenocarcinoma resection were collected,and the expression of Shh protein in lung cancer tissues and paracancerous tissues of the patients was determined by tissue microarray and immunohistochemistry.The Wilcoxon rank-sum test was used to analyze the differences in the expression of Shh protein be-tween lung cancerous tissues and paracancerous tissues.Multivariate logistic regression and Cox proportional risk regression models were used to analyze the association of Shh protein expression with pathological characteristics and prognosis of pa-tients.Results The level of Shh protein in cancerous tissues of patients with lung adenocarcinoma was significantly higher than that in paracancerous tissues(P＜0.01).The difference in Shh protein expression between cancerous tissues and paracancerous tissues of lung adenocarcinoma(difference in cancer/paracancer Shh protein expression)was negatively correlated with tumor size.For each unit increase in cancer/paracancer Shh protein IOD/Area difference,positive cell rate difference,and staining in-tensity score difference,the risks of tumor size developing larger than 7 cm were reduced by 43％,4％and 46％,and the OR and 95％CI were 0.57(0.35,0.94),0.96(0.94,0.99)and 0.54(0.35,0.86),respectively.As the difference in the rate of cancer/paracancer Shh protein-positive cells increased,the risk of tumor size developing larger than 7 cm in patients with lung adeno-carcinoma was progressively reduced(Ptrend=0.011).Cox proportional risk regression model analysis showed that for each unit increase in the difference in cancer/paracancer Shh IOD/Area value,the risk of postoperative mortality in lung adenocarcinoma patients could be reduced by 14％,with a hazard ratio(HR)and 95％CI of 0.86(0.74,0.99).Stratified analysis revealed that in patients with moderately or highly differentiated tumor cells or distant metastases,each unit increased in the cancer/paracancer Shh protein IOD/Area difference,the risks of death were reduced by 19％and 38％,respectively,with HR and 95％CI of 0.81(0.67,0.99)and 0.62(0.41,0.94),respectively.Conclusion The difference value of Shh protein expression between cancerous tissues and paracancerous tissues is negatively correlated with tumor size and risk of postoperative mortality in lung adenocarci-noma patients,suggesting that it may be a protective factor for postoperative survival,and providing a new idea for early assess-ment of prognosis in patients with lung adenocarcinoma.
lung adenocarcinomaSonic Hedgehogtumor pathological featureprognosisrisk of death
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