VEGF c-erbB-2对非小细胞肺癌辅助化疗的临床预测

Predictive Value of VEGF and c-erbB-2 Expression on Adjuvant Chemotherapy in NSCLC

目的探讨VEGF、c-erbB-2蛋白表达对非小细胞肺癌预后和辅助化疗的临床预测作用。方法应用免疫组化LSAB法检测35例根治术后行含铂类辅助化疗的Ⅲa期非小细胞肺癌VEGF、c-erbB-2蛋白的表达情况,选同期单独手术的21例Ⅲa期患者作对照,分析两项指标在单纯手术组和术后化疗组中的表达以及联合检测两项指标对预后和辅助化疗的预测作用。结果c-erbB-2蛋白表达阳性率为42.85%,阳性者和阴性者的生存率差异有显著性(P<0.05);VEGF蛋白表达阳性率53.57%,在单纯手术组中阳性者和阴性者生存率的差异有显著性(P<0.05),在术后化疗组中二者的差异无显著性(P>0.05);在单纯手术组中,将VEGF、c-erbB-2两项指标分为两项全阳性、两项全阴性、两项中任一项阳性3组,3组生存率的差异有显著性(P<0.05);在术后化疗组中将VEGF、c-erbB-2两项指标分为两项全阳性、两项全阴性、两项中任一项阳性3组,3组生存率的差异有显著性(P<0.05)。结论VEGF、c-erbB-2蛋白表达是预后较差的指标之一,预测c-erbB-2蛋白表达阳性者较阴性者对化疗不敏感,将VEGF、c-erbB-2两项指标作组合分析,能对非小细胞肺癌手术预后和术后化疗的疗效作出一定的预测。

Objective To determine the predictive value of VEGF and c - erBb - 2 expression in adjuvant chemotherapy on non-small cell lung cancer （NSCLC）. Methods Expression of VEGF and c - erBb - 2 in 35 patients with NSCLC who received radical surgery and cisplain - based chemotherapy were determined by LSAB immunohistochemical method in contrast with 21 NSCLC patients received surgery alone. Kaplan - Meier method was used to analyze the correlation of their expression with prognosis and predictive value in chemotherapy. Results The positive rate of c - erbB - 2 were 42.85% , respectively, and there was significant survival difference between the positive patients and negative ones （ P 〈 0.05 ） and in surgery alone and surgery plus chemotherapy group patients; The positive rate of VEGF was 53.57% , and there was significant difference in single surgery group （ P〈0.05 ）, but no significant difference in surgery plus chemotherapy group （ P 〉 0.05 ）;In the sigle surgery group, the patients＇expression of c -erbB -2, VEGF were subdivided into three groups （all positive, all negative and one of them positive） there showed significant survival difference between these three subgroups（ P 〈0.05 ）;The expression of c-erbB -2 in the patients who had post-operative chemotherapy were subdivided into three groups （all positive, all negative and one of them positive） , there showed significant survival difference betweem these three groups （ P 〈 0.05 ）. Conclusion Overexpression of VEGF, c - erbB - 2 protein predict poor prognosis, and overexpression of c - erbB - 2 have the tendency of resisting to chemotherapy. Combined detection of VEGF and c - erbB - 2 expression may be of predictive value on prognosis, and combined detection of and c - erbB - 2 expression may be predictive value on the response of chemotherapy in NSCLC.