化疗对非小细胞肺癌患者血清抗Survivin抗体水平的临床研究

Clinical study on the effect of chemotherapy on the serum levels of anti-survivin antibody in patients with non-small-cell lung cancer

目的通过检测非小细胞肺癌患者化疗前后血清中抗Survivin抗体水平的变化观察治疗效果,指导临床治疗。方法收集确诊的非小细胞肺癌患者260例,其中65例抗Survivin抗体阳性患者行化疗(化疗方案为吉西他滨第1、8天静脉点滴,1000mg/m2,顺铂第1～3天静脉点滴,30mg/m2。21d为1个周期,共4个周期)。全部标本的检测使用人抗Survivin抗体/生存蛋白(SurvAb)酶联免疫分析试剂盒,酶联免疫吸附双抗体夹心法定量测定人血清中抗Survivin抗体的含量。结果抗Survivin抗体在对照组中检测结果均为阴性,而在非小细胞肺癌组中阳性表达率51.5%(134/260),其表达量明显高于对照组(P<0.05)。化疗组化疗前后Survivin抗体表达比较差异有统计学意义(P<0.05)。结论抗Survivin抗体在健康人群中不表达,而在非小细胞肺癌中高表达,但在化疗第3～4周期迅速下降。

Objective To observe the changes of serum levels of anti-survivin antibody in patients with non-small-cell lung cancer before and after chemotherapy in order to investigate the therapeutic effect and to guide clinical treatment. Methods 260 patients with non-small-cell lung cancer were enrolled in the study including 158 males and 102 females ,with a mean age of 59.14 years（ age range ：20 - 78yr）, and the serum samples of 140 cases of adenocarinoma and 120 cases of squamous cancer were cellected in whom 20 cases were at stage Ⅱ of lung cancer;100 cases were at stage ILIA,30 cases were at stage ⅢB and 110 cases were at stage Ⅳ of p-TNM status. The 68 healthy subjects were collected as controls, including 49 males and 19 females. Among 260 patients with non-small-cell lung cancer, 69 patients received surgical treatment and 65 patients received chemotherapy （Gemcitabine,GEM 1 000mg/m^2 on day 1 and 8 and DDP 30 mg/m^2 on day 1 -3 every 21 days）. All the serum samples were assayed with human anti-survivin antibody ELISA kits. The levels of anti-survivin antibody were detected by ELISA method. Results The anti-survivin antibody was negative in peripheral blood of healthy subjects, however, its expression rate was 51.5 % in patients with non-small-cell lung cancer（ 134/260,69 cases in operation group and 65 cases in chemotherapy group）. There was a significant difference in the expression rate of snrvivin antibody between control group and the patient groups （ P 〈 0.05 ）. There was a significant difference in the expression rate of survivin antibody of the patients before chemotherapy and after chemotherapy（ P 〈 0.05 ）. Conclusion The anti-survivin antibody is not expressed in the peripheral blood of the healthy people, while it is expressed highly in patients with non-small-cell lung cancer patients, however,which decreases sharply in the third cycle and the fourth cycle of chemotherapy.