活化白细胞黏附分子在非小细胞肺癌组织中的表达及其与铂类化疗效果的相关性研究

Expression of CD166 in non-small cell lung cancer tissues and its relationship with platinum-based chemotherapy effect

目的 观察活化白细胞黏附分子（CD166）在晚期非小细胞肺癌（NSCLC）组织中的表达,并探讨其与NSCLC患者临床特征、铂类化疗效果的关系.方法 64例Ⅲ、Ⅳ期NSCLC患者在化疗前经纤维支气管镜或肺穿刺活检获取肿瘤组织学标本,采用免疫组织化学法检测CD166表达.患者给予2～4个周期以铂类为基础的联合化疗方案（NP/TC/GP）,采用RECIST标准评价疗效.结果 46.9％（30例）的患者CD166阳性.CD166表达与是否吸烟（吸烟62.1%,不吸烟34.3%,X^2=4.916,P=0.027）和病理分化程度（中、低分化68.2％,高分化35.7%,X^2=6.112,P=0.013）相关.CD166阳性患者化疗有效率23.3%,明显低于CD166阴性患者的61.8% （X^2 =9.565,P=0.002）.结论 晚期NSCLC存在CD166表达,且吸烟和低、中分化癌患者阳性表达率增高,CD166阳性患者铂类药物化疗有效率降低,检测CD166可以预测晚期NSCLC的铂类化疗效果.

Objective To observe the expression of CD166 in advanced non-small cell lung cancer （NSCLC）,and to explore the relationship between expression of CD166 and clinical characteristics,platinum-based chemotherapy effect of NSCLC patients.Methods A total of 64 cases of NSCLC patients at stage of Ⅲ,Ⅳ were enrolled.Tumor tissue samples were obtained before chemotherapy by bronchoscopy or lung biopsy,and immunohistochemical was used to detect the expression of CD166.All patients received platinum-based chemotherapy（NP/TC/ GP） for 2-4 cycles as the first line treatment.RECIST criterion was used for therapeutic evaluation.Results 46.9% （3 0 cases） of the patients with CD 1 6 6 was positive.The CD 1 6 6 expression was related with smoking （smoking 62.1%,no-smoking 34.3%,X^2 =4.916,P =0.027） and degree of differentiation （moderately,low grade 68.2%,high grade 35.7%,X^2 =6.112,P =0.013）.The effectiveness rate of chemotherapy in CD166 positive patients was 23.3% （7 cases）,was significantly lower than 61.8% in CD166 negative patients（21 cases,X^2 =9.565,P =0.002）.Conclusion NSCLC had CD166 expression,and the expression positive rate was increased in patients with smoking,and low differentiation cancer.The effectiveness rate of platinum-based was decreased in patients with CD166 positive expression,and detection of CD166 can predict the late NSCLC platinum-based chemotherapy effect.