检测Survivin蛋白指导NSCLC的个体化治疗

Guiding individualized therapy in advanced non-small cell lung cancer by detection of Survivin protein

目的探讨根据肿瘤组织中Survivin蛋白的表达情况指导非小细胞肺癌（NSCLC）进行个体化治疗的作用和意义。方法：17例确诊为NSCLC的患者按2：1比例随机分2组。个体化治疗组（n=78）根据组织标本中Survivin蛋白的表达情况，选择个体化方案化疗，Survivin蛋白阳性患者采用非铂化疗方案，Survivin蛋白阴性患者采用含铂类药物化疗方案；标准治疗组（n=39）选择含铂类药物的一线标准方案化疗。比较2个治疗组的化疗效果，以Kaplan—Meier法分析2个治疗组患者生存期的差异。结果NSCLC患者中Survivin蛋白表达的阳性率为51．3％；个体化治疗组和标准治疗组的化疗有效率分别为55．1％和33．3oA（X2=4．949，P=0．026），两组的平均生存期分别为13．7个月和10．8个月，个体化治疗组的疗效明显优于标准治疗组（P=0．009）。结论检测Survivin蛋白以指导NSCLC患者进行个体化治疗可以提高化疗效果，并延长生存时间。

Objective To investigate the value of detecting Survivin protein in biopsy specimens of advanced non-small cell lung cancer （NSCLC） patients for individualized therapy. Methods 117 pathologically proven NSCLC patients were enrolled and randomly assigned in 2 ： 1 ratio to either the individualized treatment group or the standard treatment group. In individualized treatment group, platinum-based chemotherapy was given to Survivin protein negative patients, chemotherapy without platinum was given to Survivin protein positive patients after Survivin assessment. The standard treatment group received first-line platinum-based chemotherapy regimen. Differences in treatment effect between the groups were statistically analyzed. Survival differences were analyzed by Kaplan-Meier survival curves. Results The expression of Survivin protein was 51.3% among 78 cases. There was statistical significance in outcome between the individualized treatment group and the standard treatment group （response rate： 55.1% vs33.3%, x2=4.949, P =0.026; mean overall s urvival：13.7 months vs 10.8 months, P = 0. 009）. Conclusions Curative effect and survival of NSCLC patients were improved by individualized therapy based on detection of Survivin protein in biopsy specimens.