神经内分泌分化与p53对非小细胞肺癌预后的影响

Clinical value of neuroendocrine differentiation markers and p53 in prognostic assessment of non small cell lung cancer

目的：探讨神经内分泌（neuroendocrine，NE）分化标志物：嗜铬蛋白A（CgA）、突触素（Syn）、神经内分泌颗粒和p53对非小细胞肺癌（non-small cell lung carcinoma，NSCLC）预后的影响。方法：62例NSCLC进行含铂类方案新辅助化疗1～2个周期，然后手术治疗，以免疫组化法检测术后标本中NE分化标志物CgA、Syn及p53，以电镜观察标本中神经内分泌颗粒，随访3年，结果采用SPSS11．0统计软件，进行生存率分析。结果：p53及NE分化标志物联合p53对非小细胞肺癌患者的无病生存期在统计学上均有显著性差异（P〈0．05），NE（＋）p53（-）患者生存率较高。说明p53和NE分化联合p53与非小细胞肺癌患者的预后有关。结论：神经内分泌分化和p53两者联合，用于非小细胞肺癌患者无进展生存期评价具有一定的临床价值。

Objective：To study the clinical value of p53 and neuroendocrine differentiation （NE） markers including chro mogranin A （CgA）, synaptophysin （Syn）, and neuroendocrine granules in prognostic assessment of non-small cell lung cancer （NSCLC）. Methods：Sixty-two patients were given platinum-based neoadjuvant chemotherapy for 1-2 cycles before surgery. Expression of CgA, Syn, and p53 in resected NSCLC specimens was determined by immunohistochemistry. NE granules were observed by electron microscope. After 3-year follow-up, survival rate was analyzed by SPSS11.0 software. Results：There was statistically significant correlation between progression free survival （PFS） and expression of p53 and NE differentiation markers （P〈0.05）. Conclusion： NE differentiation combined with p53 expression have clinic values in PFS assessment of NSCLC.