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目的:探讨新辅助化疗与Ⅲ期非小细胞肺癌骨髓微转移的关系。方法:应用RT-PCR技术,术中取肋骨骨髓检测新辅助化疗患者(化疗组)36例及直接手术患者(对照组)35例Ⅲ期非小细胞肺癌患者骨髓中CK19的表达情况。结果:化疗组CK19的阳性率为22.2%(8/36),对照组CK19的阳性率为45.7%(16/35),两组差异显著(P=0.026)。新辅助化疗疗效与CK19的表达呈负相关(P=0.026),rs=–0.372。COX模型分析提示,化疗疗效、CK19的表达是影响化疗组预后的独立指标。结论:新辅助化疗可减少Ⅲ期非小细胞肺癌骨髓微转移的发生,通过检测骨髓中CK19的表达可指导临床治疗。
Objective: To investigate the relationship between neoadjuvant chemotherapy and bone marrow micrometastasis in stage III non-small cell lung cancer. Methods: The expression of CK19 in bone marrow of 36 patients with neoadjuvant chemotherapy (chemotherapy group) and 35 patients with stage III non-small cell lung cancer (NSCLC) who underwent direct surgery (control group) were examined by RT-PCR. Results: The positive rate of CK19 in chemotherapy group was 22.2% (8/36). The positive rate of CK19 in control group was 45.7% (16/35). The difference between the two groups was significant (P=0.026). The effect of neoadjuvant chemotherapy was negatively correlated with the expression of CK19 (P=0.026), rs=–0.372. The COX model analysis suggested that the efficacy of chemotherapy and the expression of CK19 were independent indicators of the prognosis of the chemotherapy group. Conclusion: Neoadjuvant chemotherapy can reduce the occurrence of bone marrow micrometastasis in stage III non-small cell lung cancer. The detection of CK19 in bone marrow can guide clinical treatment.