IGFBP-2、-3、-5表达变化与非小细胞肺癌患者化疗敏感性的关系

Relationship between expression changes of IGFBPs-2,-3,-5 and sensitivity of NSCLC to chemotherapy

目的 探讨胰岛素样生长因子结合蛋白（insulin-like growth factor-binding protein,IGFBP）家族成员表达与非小细胞肺癌（non-small cell lung cancer,NSCLC）患者化疗效果的关系。方法 收集40例NSCLC,所有患者均接受含铂药物的一线化疗方案,根据化疗疗效将患者分为化疗敏感组和不敏感组。采用酶联免疫法和免疫组化法检测两组患者血清和癌组织中的IG-FBP-2、IGFBP-3和IGFBP-5的表达;分析IGFBP-3表达水平与NSCLC临床病理特征的关系;利用单因素分析和Logic多因素回归分析IGFBP-3低表达和NSCLC患者化疗不敏感的关系。结果 化疗敏感组患者的血清和癌组织中IGFBP-2和IGFBP-5水平略高于化疗不敏感组,但二者差异无统计学意义（P〉0.05）;化疗敏感组患者的血清和癌组织中的IGFBP-3显著高于化疗不敏感组,二者差异有统计学意义（P〈0.05）。NSCLC中发生淋巴转移和肿瘤直径较大的患者,其IGFBP-3低表达。单因素分析显示IGFBP-3低表达与化疗不敏感密切相关（OR=6.333,95%CI=1.543~26.003,P〈0.05）。Logistic回归多因素显示IGFBP-3低表达是患者发生化疗不敏感的独立危险因素（OR=4.093,95%CI=1.532~8.191,P〈0.05）。结论 IGFBP-3低表达可能引起NSCLC患者的化疗耐受,其可作为判断NSCLC患者化疗效果和预后的临床指标。

Purpose To investigate the relationship between the expression changes of insulin-like growth factor-binding protein （ IG- FBP） and the sensitivity of non-small cell lung cancer （NSCLC） patients to chemotherapy. Methods Fourty cases of patients with NSCLC were selected who undergone the first-line chemotherapy regiments. According to curative effect, all patients were divided into two groups including chemo-sensitive group and chemo-resistant group. IGFBPs （ IGFBP-2, -3 and -5 ） levels in serum and tissue samples were detected by ELASA kits and imnmnohistochemical assay, respectively. Results In chemo-sensitive group, higher levels of IGFBP-2 and IGFBP-5 were observed but the differences were not significant （P 〉 0. 05）. However, compared with the chemo-resist- ant patients, IGFBP-3 level was dramatically higher in chemo-sensitive patients both in serum and tissue samples （ P 〈 0. 05 ）. Furthermore, the patients with lymphatic metastasis and larger tumors showed a lower IGFBP-3 level. Univariate analysis showed that decreased expression of IGFBP-3 might induce chemo-resistance in NSCLC patients （ OR = 6. 333, 95% C1 = 1. 543 - 26. 003, P 〈 0.05）. Logistic multi-factor regression analysis indicated that lower IGFBP-3 was a independent risk factor for chemo-resistance （ OR =4. 093, 95% CI = 1. 532 - 8. 191, P 〈 0. 05）. Conclusion Lower IGFBP-3 may cause resistance of patients with NSCLC to chemotherapy.