肺癌癌组织中过氧化物酶增殖体激活受体γ基因表达水平对培美曲塞化疗疗效的预测价值

Predictive value of PPARγgene expression level in lung cancer tissue for curative effect of pemetrexed chemotherapy

目的:探讨肺癌癌组织中过氧化物酶增殖体激活受体γ(PPARγ)基因表达水平对培美曲塞化疗疗效的预测价值。方法:选取经组织病理学验证为晚期非小细胞肺癌(NSCLC)患者80例为研究对象,qRT-PCR检测化疗前各组患者癌组织及癌旁正常组织中PPARγ基因表达水平,所有患者均进行培美曲塞联合铂类化疗,统计客观缓解率(ORR)及疾病控制率(DCR),利用受试者工作特征曲线(ROC)评价PPARγ基因表达水平对培美曲塞化疗疗效的预测价值,并根据Cutoff值将所有患者分为PPARγ高表达组及PPARγ低表达组,Kaplan-Meier法分析PPARγ水平与患者2年生存率的关系。结果:癌组织中PPARγ基因mRNA表达水平高于癌旁正常组织,比较差异有统计学意义(P<0.05);化疗后完全缓解0例,部分缓解26例,稳定35例,进展19例,ORR为32.50%,DCR为76.25%,疾病控制组PPARγmRNA表达水平高于病情进展组,两组比较差异有统计学意义(P<0.05);ROC分析结果显示,PPARγ表达水平预测培美曲塞化疗有效的AUC=0.779,95%CI:0.673~0.885,Cutoff值为2.855;80例NSCLC患者2年内死亡42例,存活率为47.50%,Kaplan-Meier曲线结果显示PPARγ高表达组的2年总生存率58.82%(30/51)显著高于PPARγ低表达组的27.59%(8/29)。结论:高表达PPARγ基因患者应用培美曲塞化疗的效果要优于低表达PPARγ基因患者。

Objective:To explore the predictive value of peroxisome proliferator-activated receptor gamma(PPARγ)gene expression level in lung cancer tissue for curative effect of pemetrexed chemotherapy.Methods:Eighty patients with advanced non-small cell lung cancer(NSCLC)confirmed by histopathology were enrolled as study objects.The expression level of PPARγgene in cancer tissue and normal adjacent tissue in each group before chemotherapy was detected by qRT-PCR.All patients underwent pemetrexed combined with platinum chemotherapy.The objective remission rate(ORR)and disease control rate(DCR)were statistically analyzed.The predictive value of PPARγgene expression level for curative effect of pemetrexed chemotherapy was evaluated by receiver operating characteristic(ROC)curve.According to different cutoff values,all patients were divided into PPARγhigh-expression group and PPARγlow-expression group.The relationship between PPARγlevel and 2-year survival rate was analyzed by Kaplan-Meier method.Results:The mRNA expression level of PPARγgene in cancer tissue was higher than that in normal adjacent tissue(P<0.05).After chemotherapy,there were 0 case with complete remission,26 cases with partial remission,35 cases in stable stage and 19 cases in advanced stage.ORR and DCR were 32.50%and 76.25%,respectively.The mRNA expression level of PPARγgene in disease control group was higher than that in disease progression group(P<0.05).ROC analysis results showed that AUC,95%CI and Cutoff value of PPARγexpression level for predicting the effectiveness of pemetrexed chemotherapy were 0.779,0.673-0.885 and 2.855,respectively.Among the 80 NSCLC patients,there were 42 cases died within 2 years,with survival rate of 47.50%.Kaplan-Meier curve results showed that 2-year overall survival rate in PPARγhigh-expression group was significantly higher than that in PPARγlow-expression group[58.82%(30/51)vs.27.59%(8/29)].Conclusion:The effect of pemetrexed chemotherapy in patients with high-expression PPARγgene are better than that in patients with low-expression PPARγgene.