PC 细胞来源的致瘤生长因子及乳腺癌耐药蛋白表达对晚期非小细胞肺癌铂类为主化疗方案疗效影响分析

Influences of PC cell-derived growth factor and breast cancer resistance protein on the curative effects of platinum-based chemotherapeutic regimens for advaced non-small cell lung cancer

目的探讨 PC 细胞来源的致瘤生长因子(PCDGF)和乳腺癌耐药蛋白(BCRP)预测非小细胞肺癌(NSCLC)化疗疗效的前景和临床应用价值。方法对87例化疗初治晚期 NSCLC 患者的肿瘤病理组织切片进行免疫组织化学染色,观察 PCDGF 和 BCRP 的表达情况,分析其表达强弱与铂类为主的化疗方案治疗疗效的关系。结果 NSCLC 患者化疗总有效率(OR)41.4％(36/87),化疗敏感者41.4％(36/87),化疗抗拒者58.6％(51/87)。PCDGF 表达率为52.9％,化疗抗拒者 PCDGF 表达强度(74.5％)明显高于化疗敏感者(19。4％)(P=0.000),强阳性表达者均为化疗抗拒者,PCDGF表达强度与化疗疗效显著相关(P=0.000),其阳性表达灵敏度为74.5％,特异度为84.8％;BCRP 表达率为67.8％(59/87),化疗抗拒者表达强度(90.2％)明显高于化疗敏感者(36.1％)(P=0.000),强阳性表达者均为化疗抗拒者,BCRP 表达强度与化疗疗效显著相关(P=0.000),其阳性表达灵敏度为90.2％,特异度为78.0％;PCDGF 和 BCRP 联合检测共表达特异度为92.0％,可以提高预测化疗疗效的特异性。结论 PCDGF 和 BCRP 将可以成为应用临床免疫组织化学方法预测 NSCLC 一线化疗疗效的生物标记物。

Objective To investigate the influences of PC cell-derived growth factor （PCDGF） and breast cancer resistance protein （BCRP） on the curative effects of platinum-based chemotherapeutic regimens for advanced non-small cell lung cancer （NSCLC）. Methods Specimens of cancer were collected from 87 chemotherapy-naive patients with advanced NSCLC, 61 males and 26 females, aged 42 - 75. Immunohistochemistry was used to examine the expression of PCDGF and BCRP. After the collection of pathological specimens the patients underwent platinum-based chemotherapy. The relationship between the excpresion of PCDGF and BCRP and the curative effects of chemotherapy was analyzed. Results The overall response rate （OR） to chemotherapy of the 87 patients was 41.38% （36/87） , 36 of the patients were chemosensitive （41.38%）, and the other 51 were chemoresistant （58.62%）. Forty-six of the 87 patients （52.9%） were PCDGF positive, the PCDGF positive rate of the chemoresistant patients was 74. 5%, significantly higher than that of the chemosentive patients （ 19. d.%, P = 0. 000）. The patients with high PCDGF expression intensity were all chemoresistant. PCDGF expression was significantly associated with response of chemotherapy （P =0.000）. The overall positive BCRP expression rate was 67.82% （59/87）. Of the 51 chemoresistant patienents 46 were BCRP positive （90.2%）, a rate significantly higher than that of the chemosensitive patients （ 36. 1%, P = 0. 000 ）. The intensity of BCRP expression was significantly associated with response to chemotherapy （P = 0. 000）. Conclusion PCDGF and BCRP may be used as biomarkwers to predict the first-line response to chemotherapy in patients with advanced NSCLC.