术前化疗对期NSCLC基因变异的作用及其临床意义

THE EFFECT OF PREOPERATIVE CHEMOTHERAPY ON GENES IN PATIENTS WITH STAGE Ⅲ NSCLC AND ITS CLINICAL IMPLICATIONS

目的 通过检测术前化疗与单一手术组织标本之间多种癌基因与抑癌基因分子变异的差异 ,以期探讨术前化疗对 期 NSCL C患者基因变异的影响及其临床意义。方法 分别采用 DNA印迹法及 PCR技术 ,检测 75例 期NSCL C组织 DNA标本中 c- m yc、c- erb B2及 EGFR多种癌基因扩增及 71例组织中抑癌基因 p15的纯合性丢失。结果 1)术前化疗组的多种癌基因共扩增率为 35 .5 % ,而相应单一手术组为 6 3.6 % (P<0 .0 5 )。 2 ) p15的纯合性丢失率在术前化疗组为 2 3.3% ,较单一手术组的 70 .7%有显著性降低 (P<0 .0 0 1)。结论 术前化疗对 期 NSCL C患者癌细胞具有攻击及杀伤作用 ,从而不仅使癌基因的共扩增率下降 ,而且也使抑癌基因的丢失率降低。因此检测基因的变化在一定程度上有可能作为术前化疗对于

Objective To investigate the effect of preoperative chemotherapy on the alteration of oncogenes and tumor suppressor genes in locally advanced NSCLC and its clinical significance.Methods Co amplification of oncogenes were evaluated by Southern blot and slot blot for 75 patients with stage Ⅲ NSCLC and homozygous deletion of MTS2/p15 gene was determined by PCR(Polymerase chain reaction) for 71 patients. Results 1) The rate of co amplification in stage Ⅲ NSCLC patients with chemotherapy was 35.5%, while that in stage Ⅲ NSCLC without chemotherapy was 63.6%. 2) the rate of p15 gene homozygous deletion in group with chemotherapy (23.3%) was dramatically lower than in group without chemotherapy (70.7%, P <0 001). Conclusion Preoperative chemotherapy plays an important role in treatment of stage Ⅲ NSCLC patients. By attacking and killing the cancer cells, preoperative chemotherapy not only can lower the rate of oncogenes co amplification, but also the rate of p15 gene homozygous deletion. Therefore, detection of genes alleration may be used as a potential predictor for evaluating preoperative chemnotherapy in treatment of stage Ⅲ NSCLC patients.