肺腺癌C-erbB-2、p53表达与新辅助化疗有效性关系临床研究的初步报告

The elementary report of a clinical study on the relationship between the expression of C-erbB-2 or p53 and the efficacy of the neuadjuvant chemotherapy in the patients with lung adenocarcinoma

目的:观察肺腺癌C erbB2、p53表达与新辅助化疗有效性的关系。方法:2002年5月～2004年1月,我院经病理组织学确诊的肺腺癌患者38例(其中低分化腺癌24例,中分化腺癌14例),对其经石蜡包埋的肺癌组织标本采用免疫组化S P法进行C erbB2、p53蛋白表达的检测。对进入观察组的患者,进行根治性放射治疗或手术前给予长春瑞滨加顺铂(NP)方案的化疗,长春瑞滨25mg/m2,d1、d8,顺铂75mg/m2,d3。每3周为1周期,3周期化疗后评价疗效。结果:未观察到p53表达阳性、C erbB2表达阳性与化疗疗效有密切关系(P=0.19,P=0.31);但新辅助化疗有效率在C erbB2、p53表达均阳性者为22.2%(2/9),而在C erbB2、p53表达阴性者为75.0%(9/12),两者比较差异有统计学意义(P=0.027)。未观察到C erbB2、p53表达与组织学分级的相关关系(P=0.44,P=0.42)。结论:肺腺癌患者p53表达阳性、C erbB2表达阳性与化疗疗效无关;C erbB2、p53表达均阳性者对治疗NSCLC常用的NP方案敏感性低于表达均阴性者。因观察的例数尚少,最后的结论有待积累更多的病例。

Objective:To investigate the relation between the expression of C-erbB-2 or p53 and the efficacy of neuadjuvant chemotherapy in the patients with lung adenocarcinoma. Methods:From May. 2002 to Jan.2003, 38 patients with lung adenocarcinoma were eligible for our study, Of which 24 cases were low-differentiated adenocarcinoma and 14 cases were moderate-differentiated adenocarcinoma. Paraffinembedded specimens from the patients with lung adenocarcinoma were investigated by way of immunohistochemical S-P method to examine the expression of C-erbB-2 and p53. The patients enrolled in the study and received chemotherapy with the regimen of vinorelbine plus cisplatin before receiving radical radiotherapy or operation.Vinorelbine(25 mg/m^2,on day 1 and 8)and cisplatin(75mg/m^2, on day 3)were administered for one cycle, and repeated every 3 weeks. After 3 cycles of chemotherapy, the efficacy was evaluated for each patient according to the standard WHO criteria.Results:No relationship between the expression of C-erbB-2 or p53 and the chemotherapy efficacy was observed (P=0.19 and P=0.31, respectively). The response rate of neuadjuvant chemotherapy in the patients with both positive expression of C-erbB-2 and p53 was 75%(9/12),The difference of the response rates between these two groups was of significance statistically(P=0.027). No relation between the expression status of C-erbB-2 or p53 and the histological grading was found (P=0.44 and P=0.42,respectively).Conclusion:The positive expression of C-erbB-2 or p53 has no relation with the chemotherapy sensitivity in the patients with lung adenocarcinoma. The patients with expression of both C-erbB-2 and p53 had lower sensitivity to the chemotherapy with NP regimen, compared with those with no expression of both C-erbB-2 and p53. Because the number of the cases investigated was not large, further study is needed for the final conclusion.