2025 年第 3 期 第 20 卷

膜突蛋白及配对相关同源框蛋白1在老年非小细胞肺癌组织中的表达及与奥希替尼靶向治疗效果的相关性

Expression of moesin and paired related homeobox protein 1 in elderly patients with non-small cell lung cancer and their correlation with the efficacy of osimertinib targeted therapy

作者：苏斌罗成荀欣

英文作者：Su Bin Luo Cheng Xun Xin

单位：中国人民解放军联勤保障部队第九二〇医院肿瘤科，昆明650001

英文单位：Department of Oncology the 920th Hospital of the Chinese People′s Liberation Army Joint Logistic Support Force Kunming 650001 China

关键词：非小细胞肺癌；膜突蛋白；配对相关同源框蛋白1；奥希替尼靶向治疗

英文关键词：Non-smallcelllungcancer;Moesin;Pairedrelatedhomeoboxprotein1;Osimertinibtargetedtherapy

• 摘要：

• 目的 分析膜突蛋白、配对相关同源框蛋白1（PRRX1）在老年非小细胞肺癌（NSCLC）组织中表达及与奥希替尼靶向治疗效果的相关性。方法 选取中国人民解放军联勤保障部队第九二〇医院2021年1月至2024年6月收治的60例老年NSCLC患者为研究对象。收集手术切除的癌组织和癌旁组织标本，对组织中的膜突蛋白、PRRX1水平表达进行检测，分析二者表达变化与奥希替尼靶向治疗效果的相关性，并依据患者奥希替尼靶向治疗效果分为治疗有效组（42例）与治疗无效组（18例），比较2组膜突蛋白、PRRX1表达水平。分析膜突蛋白、PRRX1表达对老年NSCLC患者临床疗效的预测价值。结果 癌组织中膜突蛋白、PRRX1的阳性表达率分别为70.0%（42/60）、83.3%（50/60），细胞染色区域扩大，染色强度较高。2组病理组织类型、肿瘤最大径、TNM分期、分化程度、淋巴结转移、被膜侵犯、膜突蛋白和PRRX1阳性表达、表皮生长因子受体基因突变发生率比较差异均有统计学意义（均P＜0.05）。表皮生长因子受体（EGFR）基因野生型患者膜突蛋白阳性率高于EGFR突变型患者；PRRX1阳性表达率低于突变型患者（均P<0.05）。Spearman相关性分析结果显示膜突蛋白、PRRX1表达与临床疗效均呈正相关（r=0.339、0.558，均P＜0.001）。多因素Logistic回归分析结果显示，病理组织类型、肿瘤最大径、TNM分期、分化程度、淋巴结转移、被膜侵犯、膜突蛋白、PRRX1表达均是影响患者奥希替尼靶向治疗效果的危险因素（均P<0.001）。受试者工作特征曲线分析结果显示，膜突蛋白、PRRX1联合检测对老年NSCLC患者临床疗效的预测价值高于膜突蛋白、PRRX1单独检测。结论 在老年NSCLC患者中膜突蛋白、PRRX1表达对奥希替尼靶向治疗效果有关，可通过联合检测预测，从而为临床治疗方案调整提供参考。

• Objective  To analyze the expression of moesin and paired related homeobox protein 1 (PRRX1)in elderly patients with non-small cell lung cancer(NSCLC) and their correlation with the efficacy of osimertinib targeted therapy. Methods A total of 60 elderly patients with NSCLC admitted to the 920th Hospital of the Chinese People′s Liberation Army Joint Logistic Support Force from January 2021 to June 2024 were selected as the research objects. The expression levels of moesin and PRRX1 in cancer tissues and adjacent tissues were detected, and the correlation between the expression changes of moesin and PRRX1 and the efficacy of osimertinib targeted therapy was analyzed. According to the efficacy of osimertinib targeted therapy, the patients were divided into the effective treatment group (42 cases) and the ineffective treatment group (18 cases). The expression levels of moesin and PRRX1 were compared between the two groups. The predictive value of moesin and PRRX1 expressions for clinical efficacy in elderly patients with NSCLC was analyzed. Results The positive expression rates of moesin and PRRX1 in cancer tissues were 70.0%(42/60) and 83.3%(50/60), respectively. The staining area of cells was enlarged and the staining intensity was high. There were statistically significant differences in pathological type, tumor diameter, TNM stage, degree of differentiation, lymph node metastasis, capsule invasion, positive expression of moesin and PRRX1, and incidence of epidermal growth factor receptor gene mutation between the two groups (all P<0.05). The positive rate of moesin in epidermal growth factor receptor (EGFR) gene wild-type patients was higher than that in EGFR mutant patients, and the positive expression rate of PRRX1 was lower than that of mutant patients (both P<0.05). Spearman correlation analysis showed that the expression of moesin and PRRX1 was positively correlated with clinical efficacy (r=0.339, P<0.001; r=0.558, P<0.001). Multivariate Logistic regression analysis showed that pathological tissue type, maximum tumor diameter, TNM stage, degree of differentiation, lymph node metastasis, capsule invasion, mosin and PRRX1 expression were all risk factors affecting the efficacy of osimertinib targeted therapy (all P<0.001). Receiver operating characteristic curve analysis showed that the predictive value of combined detection of moesin and PRRX1 for clinical efficacy in elderly patients with NSCLC was higher than that of moesin or PRRX1 alone. Conclusion The expressions of moesin and PRRX1 are related to the efficacy of osimertinib targeted therapy in elderly NSCLC patients, which can be predicted by combined detection, so as to provide reference for clinical treatment plan adjustment.