摘要
目的检测老年晚期非小细胞肺癌(NSCLC)患者p53的表达情况,分析其与一线含铂化疗方案治疗NSCLC效果的关系,为NSCLC个体化治疗提供有效依据。方法选取2007年2月—2008年2月辽宁医学院附属第一医院经病理组织学诊断的73例老年晚期NSCLC患者的病理标本,将患者按照化疗方案不同分为吉西他滨(GP)组22例,长春瑞滨(NP)组23例,多烯紫杉醇(TP)组18例,培美曲塞(AP)组10例。GP组给予GP联合顺铂、卡铂化疗,NP组给予NP联合顺铂化疗,TP组给予TP联合顺铂、卡铂化疗,AP组给予AP联合卡铂化疗。采用免疫组化法检测p53表达情况,并采用实体瘤客观疗效评价标准(RECIST)对患者化疗效果进行评价。结果 4组患者性别、年龄、病理类型、临床分期、分化程度、手术方式比较,差异均无统计学意义(P>0.05)。73例患者中34例(46.6%)p53阳性表达。不同性别、年龄、临床分期、分化程度、手术方式患者p53阳性表达率比较,差异均无统计学意义(P>0.05);不同病理类型患者p53阳性表达率比较,差异有统计学意义(P<0.05)。p53阳性表达者化疗有效率为23.5%(8/34),低于p53阴性表达者的53.8%(21/39)(χ2=8.742,P=0.004)。不同病理类型化疗有效率比较,差异无统计学意义(χ2=4.588,P=0.332)。不同化疗方案有效率比较,差异无统计学意义(χ2=5.421,P=0.143)。多因素Logistic回归分析结果显示,p53表达为NSCLC患者疗效的影响因素(P<0.05)。Kaplan-Meier生存分析显示,经不同化疗方案治疗后,NSCLC患者p53阳性表达者与p53阴性表达者总生存期(OS)比较,差异有统计学意义(χ2=10.319,P=0.002)。结论 p53阳性表达会影响NSCLC患者接受一线含铂化疗的疗效。
Objective To observe the expression of p53 in elderly patients with advanced non- small cell lung cancer（ NSCLC）, and analyze its relationship to first- line chemotherapeutics plus platinum, to provide effective basis for individualized treatment of NSCLC. Methods From February 2007 to February 2008, in the First Affiliated Hospital of Liaoning Medical University, the pathological specimens of 73 advanced NSCLC patients were divided, according to chemotherapeutic regimens,into groups GP（ n = 22）,NP（ n = 23）,TP（ n = 18）,AP（ n = 10）. GP group were given Gemcitabine combined with Cisplatin, Carboplatin, NP group given Navelbine with Cisplatin, TP group given Taxotere with Cisplatin,Carboplatin,AP group given Alimta with Cisplatin,Carboplatin. This study used immunohistochemistry to detect p53 expression and used Response Evaluation Criteria in Solid Tumors（ RECIST） to assess the effect of chemotherapy. Results There was no significant difference in gender,age,pathological types,clinical stages,degree of differentiation,surgical modes in 4 groups（ P〉0. 05）. In 73 patients,34（ 46. 6%） had positive expression of p53. There was no difference in p53 positive expression between patients of different genders,ages,with different clinical stages,degrees of differentiation,surgical modes（ P〉0. 05）,there was significarnt difference in p53 positive expression between patients with different pathological types（ P〈0. 05）. The chemotherapeutic effective rate of patients with positive p53 expression was 23. 5%（ 8 /34）, lower than that of patients with negative p53 expression（ 53. 8%,21 /39）（ χ2= 8. 742,P = 0. 004）. There was no difference in effective rate in patients with different pathological types（ χ2= 4. 588,P = 0. 332）,in different chemotherapeutic regimens（ χ2= 5. 421,P= 0. 143）. Multivariate Logistic regression analysis showed that p53 expression was a factor influencing chemotherapeutic effect on NSCLC（ P〈0. 05）. Kaplan- Meier survival analysis showed that there was significant difference in overall survival between NSCLC patients with positive p53 expressions and those with negative（ χ2= 10. 319,P = 0. 002）. Conclusion p53 expression is a influencing factor for effectiveness of first- line platinum- containing chemotherapy for NSCLC patients.
出处
《中国全科医学》
CAS
CSCD
北大核心
2015年第9期989-993,共5页
Chinese General Practice
基金
辽宁省科学技术计划项目(2012225019)
关键词
癌
非小细胞肺
老年人
基因
p53
铂化合物
治疗结果
Carcinoma
non-small-cell lung
Aged
Genes
p53
Platinum compounds
Treatment outcome
