晚期非小细胞肺癌中Bmi-1表达与一线化疗敏感性及预后的相关性分析

Correlation Analysis of Bmi-1 Expression with First-Line Chemosensitivity and Prognosis in Advanced Non-small Cell Lung Cancer

目的研究晚期非小细胞肺癌中Bmi-1表达与一线化疗敏感性及预后的相关性。方法选择2014年1月—2016年12月在我院诊断为晚期非小细胞肺癌(NSCLC)的108例患者为研究对象,采用免疫组化法检测NSCLC组织中Bmi-1的表达;一线化疗后评价患者疗效,获得完全缓解(CR)和部分缓解(PR)为化疗敏感,采用卡方检验分析化疗反应率的差异,Logistics模型分析化疗敏感性的影响因素;随访患者总生存期(OS),采用Kaplan-Meier曲线分析OS的差异,Cox模型分析OS的影响因素。结果 108例NSCLC患者中,Bmi-1高表达66例(61.11%),且不同年龄、性别、行为状态(PS)评分、组织类型、分化程度、化疗方案的晚期NSCLC患者Bmi-1表达水平无明显差异(P>0.05);Bmi-1高表达者的化疗反应率显著低于Bmi-1低表达者(P<0.05),且Bmi-1高表达是化疗敏感性的独立影响因素(P<0.05);Bmi-1高表达患者的OS显著短于低表达者(P<0.05),且Bmi-1表达、一线化疗敏感性是OS的影响因素(P<0.05)。结论 Bmi-1高表达与晚期NSCLC一线化疗敏感性及预后有关,Bmi-1可能成为预测晚期NSCLC一线化疗疗效及远期生存的标志基因之一。

Objective To study the correlation of the expression of Bmi-1 with the first-line chemosensitivity and prognosis of advanced non-small cell lung cancer(NSCLC) patients. Methods Between January 2014 and December 2016, 108 patients diagnosed with advanced NSCLC in our hospital were selected as the research objects. The expression of Bmi-1 in NSCLC tissues was detected by immunohistochemistry. After the first-line chemotherapy, the curative effect was evaluated. The complete remission(CR) and partial remission(PR) cases were obtained as chemosensitivity, and were taken to calculate the response rate. The difference of chemosensitivity was analyzed by chi-square test, and the influencing factors of chemosensitivity were analyzed by Logistics model. The overall survival(OS) was followed up and the difference of OS was analyzed by Kaplan-Meier curve. The influencing factors of OS were analyzed by Cox model. Results Among the 108 NSCLC cases, 66 cases(61.11%) had high expression of Bmi-1. No significant differences were found in the expression of Bmi-1 among the advanced NSCLC patients with different ages, gender, performance status(PS), tissue types, differentiation degrees and chemotherapy plans(P>0.05). The chemotherapy response rate of the patients with high expression of Bmi-1 was lower than that of the patients with low expression of Bmi-1(P<0.05), and the high expression of Bmi-1 was an independent factor of chemosensitivity(P<0.05). The OS of patients with high Bmi-1 expression was shorter than that of patients with low Bmi-1 expression(P<0.05). The expression of Bmi-1 and the sensitivity to first-line chemotherapy were the influencing factors of OS(P<0.05). Conclusion The high expression of Bmi-1 is related to the sensitivity and prognosis of first-line chemotherapy for advanced NSCLC. Bmi-1 may be a marker gene to predict the efficacy and long-term survival of first-line chemotherapy for advanced NSCLC.