β-tubulin表达与非小细胞肺癌患者术后诺维本联合铂类辅助化疗预后的关系  

Relationship between β-Tubulin Expression and Prognosis following Adjuvant Vinorelbine Chemotherapy in Operable Non-Small Cell Lung Cancer

作　　者：邓秋华[1] 林勇平[2] 杨海虹[3] 邱源[3] 刘君[3] 张鑫[3] 熊信国[3] 莫明聪[4] 何萍[4] 莫莉莉[1] 何建行[5] 

机构地区：[1]广州医学院第一附属医院转化医学研究实验室,广州市510120 [2]广州医学院第一附属医院检验科,广州市510120 [3]广州医学院第一附属医院呼吸疾病研究所胸外科,广州市510120 [4]广州医学院第一附属医院病理科,广州市510120 [5]广州医学院第一附属医院 呼吸疾病研究所胸外科,广州市510120

出　　处：《中国肿瘤临床》2012年第19期1410-1414,共5页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨β微管蛋白(β-tubulin)在非小细胞肺癌(NSCLC)中的表达情况,及其与诺维本/铂类(NP)术后辅助化疗预后的关系。方法:回顾性分析广州医学院第一附属医院2002年1月至2009年12月收治的84例手术完全切除或部分切除的NSCLC患者,术后以NP方案辅助化疗。应用免疫组织化学S-P法检测患者手术标本β-tubulin中蛋白的表达,进一步分析其与无病生存时间(DFS)和总生存时间(OS)的关系。结果:NSCLC患者中β-tubulin蛋白的低表达率为42.9%(36/84),高表达率为57.1%(48/84),男性β-tubulin高表达患者多于低表达患者(68.2%vs.31.8%,P=0.032);Ⅰ～Ⅱ期β-tubulin高表达患者多于低表达患者(70.7%vs.29.3,P=0.014);且行根治性手术β-tubulin高表达患者多于低表达患者(61.6%vs.38.4%,P=0.032),与NSCLC患者的年龄、病理类型、病理分级、淋巴结转移、吸烟史和放疗均无统计学相关性(P>0.05)。单因素生存分析显示,经低表达β-tubulin的NP方案辅助化疗的NSCLC患者,中位DFS短于高表达者(22.6 vs 69.6个月),两者之间差异无统计学意义(P=0.052),但高表达β-tubulin患者的DFS在术后13个月后明显优于低表达者;进一步分层分析显示,年龄>60岁(P=0.032)、腺癌(P=0.034)、中高分化程度(P=0.028)、不吸烟(P=0.016)的β-tubulin高表达者的DFS均明显优于低表达者。、多因素生存分析显示,β-tubulin的表达(RR=2.213,P=0.025)和临床分期(RR=0.319,P<0.0001)可作为影响DFS的独立预后因素;临床分期(RR=0.426,P=0.010)和放疗(RR=2.381,P=0.026)可作为影响OS预后的独立指标。。结论:在术后辅以NP化疗NSCLC患者中,β-tubulin高表达者预后比低表达者好,术后化疗前对β-tubulin蛋白进行免疫组织化学检测,有利于制定个体化治疗方案,可能改善生存。Abstract Objective： To detect the expression of β-tubulin in human non-small cell lung carcinoma （NSCLC） and investigate its relationship with prognosis following post-operative adjuvant vinorelbine/platinum chemotherapy. Methods： This article retrospectively analyzed 84 patients with NSCLC who had undergone adjuvant vinorelbine/platinum chemotherapy. The expression of β-tubulin protein was examined by immunohistochemistry （SP method）. The relationships of β-tubulin with disease-free survival （DFS） and overall survival （OS） were analyzed. Results： Low β-tubulin expression was identified in 36 of 84 samples （42.9%）, and high β-tubulin expression was identified in 48 of 84 samples （57.1%）. We found that in male（68.2% vs. 45.0%, P-=-0.032）, stages I - II （70.7% vs. 44.2%, P=-0.014）, radical surgery（61.6% vs. 38.4%, P=0.032）, high [3-tubulin expression was more frequent than low expression. High 13-tubulin expression was not associated with age, pathological type, pathological grade, history of smoking, metestasis status, and radiotherapy status （P〉0.05）. Univariate analysis showed that the median DFS was significantly worse in NSCLC patients with low β-tubulin expression after adjuvant vinorelbine chemotherapy than in those with high β-tubulin expression （22.6 mo vs. 69.6 mo）. However, the difference was not statistically significant （P 〉 0.05）. DFS was significantly better in patients with high expression than those with low expression 13 mo after surgery. Furthermore, we found that NSCLC patients, aged more than 60 yr, with high β-tubulin expression （P=0.032）, adenocarcinoma （P=0.034）, moderately to highly differentiated diseases （P=--0.028）, and were non-smokers （P=-0.016） had significantly better DFS than those with low expression. Multivariate Cox regression analysis showed that 13-tubulin （RR--2.213, P=0.025） and the clinical TNM stage （RR=0.319, P〈0.0001） aresignificant independent predictors of DFS for patients with l

关 键 词：β-tubulin非小细胞肺癌 诺维本预后 辅助化疗 

分 类 号：R734.2[医药卫生—肿瘤]