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目的 :化疗耐药是影响非小细胞肺癌 (NSCLC)预后的主要原因 ,本研究旨在探讨进展期NSCLC化疗耐药与凋亡相关基因p5 3、p16和bcl- 2的关系。方法 :用免疫组化方法检测进展期NSCLCp5 3、p16和bcl- 2的表达 ,同时收集患者的临床资料及化疗方案 ,比较p5 3、p16和bcl- 2表达与化疗疗效的关系。结果 :共有 14 1患者纳入研究 ,男性 12 1例 ,平均年龄 6 3岁 ;Ⅲ期 6 7例 ,Ⅳ期 76例 ;p5 3阳性 72例 (5 1% ) ,p16阴性 83例(5 9% ) ,bcl- 2阳性 15例 (10 % )。p5 3阳性组患者化疗有效率为 2 6 % ,p5 3阴性组化疗有效率为 5 7% ,两者相关显著 (P =0 0 0 4 )。结论 :本研究探讨了以顺铂为基础的联合化疗与p5 3表达的关系 ,对指导进展期NSCLC治疗及判断预后有一定意义。
OBJECTIVE: Chemoresistance is the main reason that affects the prognosis of non-small cell lung cancer (NSCLC). The purpose of this study was to investigate the relationship between chemoresistance and apoptosis-related genes p5 3, p16 and bcl-2 in advanced NSCLC. Methods: The expression of NSCLCp5 3, p16 and bcl-2 in advanced stage was detected by immunohistochemistry. The clinical data and chemotherapy regimen were collected. The relationship between p5 3, p16 and bcl-2 expression and the curative effect of chemotherapy were compared. RESULTS: A total of 141 patients were enrolled in this study. There were 12 males and 12 females with a mean age of 63 years. Sixty-seven patients were in stage III and 76 in stage IV. 72 patients (51%) were positive for p53 and 83 (59% ), bcl-2 positive in 15 cases (10%). The effective rate of chemotherapy in p5 3 positive group was 26%, while that in p5 3 negative group was 57%. There was a significant correlation between them (P = 0.004). CONCLUSIONS: This study explored the relationship between cisplatin-based combination chemotherapy and p5 3 expression, which may be of some value in guiding the progression of NSCLC and prognosis.