【摘要】 目的：探讨ⅳ期非小细胞肺癌(nsl) βⅲtubulin表达与紫杉类化疗耐药性关系. 方法： 回顾性分析75例接受以紫杉类化疗的ⅳ期nsl临床病理资料. 免疫组织化学法检测肿瘤标本βⅲtubulin蛋白表达，并对化疗疗效及生存时间进行分析. 结果： βⅲtubulin阳性表达率（≥50%阳性染色细胞）为58.7% (44/75)，与性别、年龄及组织类型无关. 化疗有效率（r+pr）为34.7%，βⅲtubulin高表达患者紫杉类化疗有效率低（25.0%)，进展率高(25.0%)，而βⅲtubulin低表达患者化疗有效率高（48.9%)，进展率低（6.4%)，p值分别为0.036和0.037. βⅲtubulin高表达者有较短的中位s（12 ）和pfs（8 ），而βⅲtubulin低表达患者有较长的中位总生存期（s）（15 ）和无进展生存期（pfs）（11 ）， p=0.018. 结论： βⅲtubulin高表达nsl患者对紫杉类药物耐药且预后不良.
【关键词】 非小细胞肺癌；紫杉醇；微管蛋白；抗药性；免疫组织化学
河北省科技支撑计划项目（072761486）
relatinship beteen expressin f βⅲtubulin and drug resistane t taxane in stage iv nnsall ell lung aner
yang junquan, ga xianshu，liu hngxia， han hun
1departent f surgery, hebei edial university, shijiazhuang 050017, hina,2departent f pathlgy, tangshan uniipal unin hspital, tangshan 063000, hina
【abstrat】 ai: t investigatethe the relatinship beteen the expressin f βⅲtubulin prtein and heresistane t taxane in nnsall ell lung aner (nsl). ethds: seventyfive patients ith stage ⅳ nsl treated ith taxane ere enrlled in this study and their linial data ere analyzed retrspetively. the expressin f βⅲtubulin prtein in tur saples as deteted by the iunhistheial ethds. the data f therapeutial effet and survival tie ere lleted and analyzed. results: the βⅲtubulin psitive staining rate（≥50% f stained ells） aunted fr 58.7% (44/75). there as n rrelatin beteen βⅲtubulin psitive expressin and age, gender, and pathlgial type. the respnse rate (r+pr) as 34.7%. patients ith βⅲtubulin verexpressin displayed less respnse rate and re prgressin rate t taxane (respnse rate 25.0%, pd 25.0% in patients ith ≥50% f stained ells vs respnse rate 48.89%, pd 6.5% in patients ith <50%, p=0.036 and p=0.037, respetively). verexpressin f βⅲtubulin prtein expressin as rrelated ith shrter edian verall survival (12 nths） and prgressinfree survival (8 nths), hile a l level f βⅲtubulin prtein expressin as rrelated ith lnger edian verall survival (15 nths) and prgressinfree survival (11 nths), p=0.018. nlusin: verexpressin f βⅲtubulin in tur ells is assiated ith resistane t taxane and a pr prgnsis in patients ith nsl reeiving taxane based hetherapy.
【keyrds】 nnsall ell lung aner; palitaxel; tubulin; drug resistane; iunhistheistry
0引言
肺癌是世界上最常见的恶性肿瘤，在恶性肿瘤相关死亡原因中占第一位. 非小细胞肺癌（nnsall ell lung aner，nsl）占所有肺癌病例的80%～85%. ⅳ期患者约占nsl的40%，其5 a生存率约为1%. 紫杉醇和多西紫杉醇等与铂类联合的有效率也仅为30%～40%，肿瘤耐药性的产生是化疗失败的最主要因素. 研究表明，βⅲtubulin表达与紫杉类耐药密切相关［1］. 国内未见到βⅲtubulin蛋白表达与nsl紫杉类耐药方面研究报道，我们回顾性分析75例ⅳ期nsl的βⅲtubulin蛋白表达，探讨其表达与紫杉类化疗效的关系.
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