含铂方案治疗进展期NSCLC与p53、p16、bcl-2表达的关系

Relationship of p53,p16 and bcl-2 Expression and Cisplatin Based Chemotherapyin Advanced Non-small Cell Lung Cancer

目的 :化疗耐药是影响非小细胞肺癌 (NSCLC)预后的主要原因 ,本研究旨在探讨进展期NSCLC化疗耐药与凋亡相关基因p5 3、p16和bcl- 2的关系。方法 :用免疫组化方法检测进展期NSCLCp5 3、p16和bcl- 2的表达 ,同时收集患者的临床资料及化疗方案 ,比较p5 3、p16和bcl- 2表达与化疗疗效的关系。结果 :共有 14 1患者纳入研究 ,男性 12 1例 ,平均年龄 6 3岁 ;Ⅲ期 6 7例 ,Ⅳ期 76例 ;p5 3阳性 72例 (5 1% ) ,p16阴性 83例(5 9% ) ,bcl- 2阳性 15例 (10 % )。p5 3阳性组患者化疗有效率为 2 6 % ,p5 3阴性组化疗有效率为 5 7% ,两者相关显著 (P =0 0 0 4 )。结论 :本研究探讨了以顺铂为基础的联合化疗与p5 3表达的关系 ,对指导进展期NSCLC治疗及判断预后有一定意义。

Objective： Chemotherapy resistance is a great obstacle for the prognosis of non- small cell lumg cancer （NSCLC）. This study evaluated the relationships and interaction between p53, p16 and bcl- 2 immunostaining, the apoptosis related gene, and response to cisplatin- based chemotherapy in advanced non- small- cell lung cancer. Methods： Histological specimens obtained by bronchial, fine - needle or metastasis nodes biopsy from patients who underwent cisplatin - based chemotherapy were evaluated by p53, p16 and bcl - 2 immunostaining. Results： There are 141 patients, men 121. Median age was 63 years; 67 had stage Ⅲ and 76 stage Ⅳ disease. Seventy- two tumor samples （51%） had tmsitive immunostaining for p53, 83 （59%） had negative immunostaning for p16 and 15 （ 10% ） had positive immunostaining for bcl - 2. The restmnse rate of the group with p53 positive immunostaining was 26% versus 57% of the p53 negative group （ P = 0.004）. Conclusion： Our study confirmed that an association of p53 immunostaining and response rate in advanced NSCLC patients treated with cisplatin - based chemotherapy.