非小细胞肺癌紫杉醇化疗耐药前后血清CK18水平的变化

Changes of serum CK18 levels before and after resistance to paclitaxel chemotherapy in patients with non-small cell lung cancer

目的研究血清细胞角蛋白18(CK18)水平与非小细胞肺癌患者紫杉醇化疗耐药的关系。方法以紫杉醇联合卡铂方案化疗(2～6个周期)第1个周期结束时点RECIST疗效评价为病情稳定或以上的30例非小细胞肺癌患者作为研究对象,采集第1个治疗周期结束时点及出现病情进展(耐药)时点的外周血样本。ELISA双抗体夹心法检测耐药前后患者血清CK18水平。结果患者耐药前后血清CK18水平分别为(0.356±0.199)ng/mL和(0.566±0.189)ng/mL,差异有统计学意义(P=0.002);其中4例患者血清CK18水平略有下降(<20%),均为化疗第2个周期结束时点疗效评价为病情进展(即耐药)的患者;其余26例患者血清CK18水平表现为升高,且均为接受至少3个周期化疗后发生病情进展的患者;其中20例增高大于20%,最高达947.17%。结论血清CK18水平与非小细胞肺癌患者紫杉醇化疗耐药有关。血清CK18水平检测可为晚期非小细胞肺癌患者的个性化治疗提供参考依据。

Objective To investigate the relationship between serum cytokeratin 18 （CK18） levels and resistance to paclitaxel chemotherapy in patients with non-small cell lung cancer. Methods Thirty patients with non-small cell lung cancer in stable or better state of illness evaluated with RECIST at the end of first cycle of chemotherapy with paclitaxel and carboplatin （2 to 6 cycles） were enrolled, and peripheral blood samples were taken at the end of first cycle of chemotherapy and at the onset of disease progression （drug resistance）. Serum CK18 levels were detected by ELISA before and after drug resistance. Results The serum CK18 levels before and after drug resistance were （0.356±0.199） ng/mL and （0.566±0.189） ng/mL, respectively, and there were significant differences between them （P=0.002）. Serum CK18 levels slightly decreased （by less than 20%） in 4 patients, all of whom were evaluated as disease progression （drug resistance） at the end of second cycle of chemotherapy. For the other 26 patients with increased serum CK18 levels, all experienced disease progression after at least 3 cycles of chemotherapy, with 20 patients increased by more than 20% （maximum, 947.17%）. Conclusion Serum CK18 levels are associated with resistance to paclitaxel chemotherapy in patients with nonsmall cell lung cancer, and detection of CK18 levels may provide references for individual treatment of patients with advanced non-small cell lung cancer.