非小细胞肺癌组织中C—erbB-2蛋白的表达对预后和术后化疗疗效的影响

Effects of C-erbB-2 protein expression on prognosis and adjuvant chemotherapy in non-small cell lung cancer

目的探讨C-erbB-2蛋白表达对非小细胞肺癌预后和术后化疗效果的影响。方法应用免疫组织化学LSAB方法检测18例根治术后行含铂类辅助化疗的Ⅲa期非小细胞肺癌（术后化疗组）石蜡切片中C—erbB-2蛋白的表达情况，选同期单独手术的15例Ⅲa期患者（单纯手术组）作为对照，应用Kaplan-Meier法和多变量Cox比例风险模型进行分析。结果（1）C—erbB-2蛋白表达与年龄、T分期之间未发现相关性（P〉0．05），但与组织学分级呈负相关（P〈0．05）。（2）C-erbB-2蛋白表达阳性率为45．45％。在单纯手术组、术后化疗组中阳性者和阴性者生存率差异具有统计学意义（P〈0．05）。（3）多因素Cox风险模型分析，提示C-erbB-2蛋白、p53是影响术后化疗效果的独立指标。结论c-erbB-2蛋白表达是预后较差的指标之一。其表达阳性者较阴性者对化疗不敏感，如何提高术后化疗疗效尚需深入研究。

Objective To determine the effects of C-erbB-2 protein expression on prognosis and adjuvant chemotherapy in non-small cell lung carcinoma （NSCLC）. Methods Expression of C-erbB-2 protein in 18 patients with NSCLC who received radical surgery and eisplatin-based chemotherapy after operation were detected（surgery plus chemotherapy group）by LSAB method in contrast with 15 patients with NSCLC received surgery alone （single surgery group）. Kaplan-Meier method and Cox proportional hazard model were used to analyze. Results （ 1 ）The expression of C-erbB-2 protein had no relationship with age and T stage （P 〉 0.05）. but had negative relationship with histological grade（P 〈 0.05 ）. （2）The positive rate of C--erbB-2 protein was 45.45%, there was significant difference between patients with positive and negative C-erbB-2 protein expression in single surgery and surgery plus chemotherapy group （P 〈 O.05）.（3）Cox＇s model showed that C-erbB-2 protein and p53 had separately impacts on prognosis in surgery plus chemotherapy group. Conclusions Overexpression of C-erbB-2 protein suggests poor prognosis, overexpression of C-erbB-2 protein has tendency resist to chemotherapy in NSCLC.