早期非小细胞肺癌预后基因标志研究现状与思考

Current situation and thinking of the prognostic gene markers＇ in early-stage non-small-cell lung cancer

非小细胞肺癌同一TNM分期患者的预后存在巨大差异，即便是早期（I、Ⅱ期）患者根治术后的生存率亦明显低于预期，说明基于解剖学特征的现有TNM分期系统尚不足以充分反映预后。更兼早期肿瘤生长的不充分，限制了解剖学特征的预后反映力度，由此而产生一系列着眼于肿瘤组织本身生物学特性的研究，以期找到对不良预后有提示作用的基因标志。这一系列研究主要基于生物芯片和定量PCR技术，运用生物信息学方法进行数据分析。目前研究现状错综复杂，背景相似的不同研究所获标志基因甚少重叠，一方面亟需研究流程的标准化，另一方面需跳出若干基因简单组合的窠臼，基于肿瘤信号通路组合预后基因标志的思路或更具有科学性、系统性，是未来的重要发展方向。

Non-small-cell lung cancer （NSCLC） patients with the same TNM stage may suffer from large prognosis variations. Even patients with early-stage NSCLC still demonstrated lower-than-expecting survival rates after surgical resection, indicating that the current staging methods which were based on anatomy do not adequately predict outcome. Especially the insufficient growth of very early period tumors limited the prognostic prediction of anatomy characteristics, therefore studies focusing on tumor biologic characteristics were developed in order to identify prognostic gene markers. A variety of prognostic genomic models were based on microarray analysis and quantitative polymerase chain reaction （PCR） and analyzed by bioinformatics data processing. However, the prognostic gene lists reported to date overlapped poorly in the studies with similar background. To improve the cloudy situation, the research protocol should be standardized. On the other hand, instead of simple addition of several genes, sequential combination of prognostic gene markers based on signal pathway should be developed which may possess much more rationality and systematicness.