ⅠB期非小细胞肺癌中K-ras的表达对辅助化疗预后的影响  

Expression of K-ras in stage ⅠB non-small cell lung cancer and its effects on prognosis after adjuvant chemotherapy

作　　者：刘明[1] 姜格宁[1] 周彩存[1] 丁嘉安[1] 王海峰[1] 何文新[1] 范江[1] 

机构地区：[1]同济大学附属上海市肺科医院胸外科,上海200433

出　　处：《肿瘤》2009年第4期367-369,共3页Tumor

摘　　要：目的:回顾性研究ⅠB期非小细胞肺癌(non-small cell lung cancer,NSCLC)中K-ras的表达,探讨其与辅助化疗(含铂类的两药方案)预后的关系。方法:75例根治性切除的NSCLC患者分为辅助化疗组和单纯手术组。应用免疫组织化学法检测NSCLC中K-ras的表达情况。全组随访患者的生存情况,并用Cox多因素分析法分析K-ras表达及临床病理参数中的独立预后因素。结果:辅助化疗组和单纯手术组的5年生存率分别为65.6%和56.3%(χ2=3.105,P=0.097);辅助化疗组中,K-ras表达为阳性患者的生存情况明显好于单纯手术组,5年生存率分别为63.5%和50.4%(χ2=5.695,P=0.026);K-ras表达为阴性时辅助化疗组与单纯手术组的患者生存率差异无统计学意义(χ2=2.618,P=0.155)。经多因素分析,组织类型、分化程度、K-ras表达和是否化疗均为NSCLC的独立预后因素,相对危险比分别为1.223、2.812、1.779和2.964。结论:K-ras阳性表达时,对ⅠB期NSCLC患者进行辅助化疗,受益明显。Objective ：To analyze the expression of K-ras in stage ⅠB non-small cell lung cancer （NSCLC） retrospectively and explore its association with prognosis after postoperative adjuvant chemotherapy. Methods： A total of 75 patients with NSCLC who received resection surgery were analyzed retrospectively. The patients were divided randomly into platinum-based adjuvant chemotherapy group （4 to 6 cycles） or single surgery group. The expression of K-ras in NSCLC was examined by immunohistochemical technique. Results：The five-year survival rates were 65.6% and 56.3 % for neoadjuvant chemotherapy group and single surgery group, respectively （P = 0.097 ）. The survival rate of K-ras-positive patients was higher than that in K-ras-negative patients in neoadjuvant chemotherapy group （63.5% vs 50.4%, X2 = 5. 695, P=0. 026）. The survival rate of K-ras-negative patients in neoadjuvant chemotherapy group had no significant difference with that in single surgery group patients （X2 = 2. 618, P = 0. 155 ）. Multivariate analysis indicated that histological classifications, differentiation degree, K-ras expression, and adjuvant chemotherapy were independent prognostic factors for NSCLC. The relative risk （RR） was 1. 223, 2. 812, 1. 779, and 2. 964, respectively. Conclusion： K-ras-positive patients with Ⅰ B NSCLC obtained better benefits from neoadjuvant chemotherapy.

关 键 词：癌 非小细胞肺 抗肿瘤联合化疗方案 预后 基因 K-RAS 

分 类 号：R734.2[医药卫生—肿瘤] R730.7[医药卫生—临床医学]