检测P53蛋白表达在Ⅲ期非小细胞肺癌新辅助化疗中的意义

Significance of detection of P53 expression in neoadjuvant chemotherapy for stage Ⅲ non-small cell lung cancer

背景与目的新辅助化疗能有效提高Ⅲ期非小细胞肺癌(NSCLC)患者的生存率,其主要体现在有效化疗的患者身上,P53在其中的临床意义未见有相关报道。本研究旨在探讨Ⅲ期NSCLC患者中P53蛋白表达与新辅助化疗敏感性及预后的关系,同时探讨P53蛋白表达与CT检查在判断新辅助化疗疗效中的相关性。方法51例行新辅助化疗患者为试验组,49例同期未行新辅助化疗者为对照组,应用免疫组化法检测两组P53蛋白表达。试验组患者于新辅助化疗前后均行CT检查。结果(1)对照组P53蛋白阳性表达率48.98%,中位生存时间18个月,试验组P53蛋白阳性表达率49.02%,中位生存时间19个月,二者无显著差别(P>0.05)。(2)试验组中P53阳性者中位生存时间13个月,阴性者中位生存时间31个月,二者有显著差别(P<0.05)。(3)胸部CT检查示新辅助化疗有效率为43.14%(22/51),同时CT为有效同时P53蛋白表达为阴性者18例,CT为无效同时P53表达为阳性者2例,P53表达与CT所示有效率具有相关性(r=0.537,P<0.01)。结论(1)检测P53蛋白表达有助于预测Ⅲ期NSCLC新辅助化疗疗效。(2)P53蛋白表达与胸部CT检查的化疗有效率相关。

Background and objective Neoadjuvant ehemotheropy can improve the survival rate of patients with stage Ⅲ non-small cell lung cancer （NSCLC）, whose chemotherapy is valid. The value of P53 expression in stage Ⅲ NSCLC has not been reported. This study is to investigate the value of P53 expression on neoadjuvant chemotherapy sensitivity and prognosis in stage Ⅲ NSCLC and to investigate the relationship between P53 expression and the result from thoracic CT examination. Methods By immunohistoehemieal technique, the expression of P53 in 51 patients with stage Ⅲ NSCLC who received neoadjuvant chemotherapy was determined in eontrast with 49 patients with stage Ⅲ NSCLC without neoadjuvant chemotherapy. Every patient who received neoadjuvant chemotherapy was examined by thoracic CT before and after neoadjuvant ehem otherapy. Results （1） There was no significant difference in the positive rate of P53 and the median survival time between neoadjuvant group and control group （48. 98% vs 49. 02% and 18 months vs 19 months）. In neoadjuvant chemotherapy group, the median survival time was significantly different between P53 positive patients and P53 negative ones （13 months vs 31 months）. （2） The expression of P53 was related to the neoadjuvant chemotherapeutic response by the results from thoracic CT examination （r=0.537, P〈0.01）. Conclusion （1）Detection of P53 expression might be helpful to predict the effect of neoadjuvant chemotherapy. （2） The expression of P53 and the neoadjuvant chemotherapeutic results from thoracic CT examination are correlated.