p53 c-erbB-2 VEGF蛋白表达对非小细胞肺癌辅助化疗的临床预测  

Predictive Value of p53,c-erbB-2and VEGF Expression on Ad juvant Chemotherapy in NSCLC

作　　者：余辉[1] 吴一龙[2] 戎铁华[1] 李锦添[3] 王思愚[1] 区伟[1] 侯景辉[4] 林素瑕[4] 

机构地区：[1]中山医科大学肿瘤防治中心胸外科,广州市510060 [2]中山医科大学肺癌研究中心第三附属医院心胸外科 [3]中山医科大学肿瘤防治中心肿瘤研究所 [4]中山医科大学肿瘤防治中心病理科

出　　处：《中国肿瘤临床》2003年第1期1-4,共4页Chinese Journal of Clinical Oncology

基　　金：广东省科技厅重点攻关项目基金;广州市科技局重点项目基金资助(99M04903G;2001-2-044-01)

摘　　要：目的:探讨p53、c-erbB-2、VEGF蛋白表达对非小细胞肺癌预后和辅助化疗的临床预测作用。方法:应用免疫组化LSAB方法检测18例根治术后行含铂类辅助化疗的Ⅲa期非小细胞肺癌石蜡切片中p53、c-erbB-2、VEGF蛋白的表达情况,选同期单独手术的15例Ⅲa期患者作对照,分析三项指标在单纯手术组和术后化疗组中的表达以及联合检测三项指标对预后和辅助化疗的预测作用。结果:1)p53、c-erbB-2蛋白表达阳性率分别为54.72%和47.17%,两组中阳性者和阴性者的生存率差异具有显著性(P<0.05)。2)VEGF蛋白表达阳性率54.72%,在单纯手术组中阳性者和阴性者生存率的差异具有显著性(P<0.05),在术后化疗组中二者的差异无显著性(P>0.05)。3)在单纯手术组中,将p53、c-erbB-2、VEGF3项指标分为3项全阳性、3项全阴性、3项中任1～2项阳性3组,3组生存率的差异具有显著性(P<0.05)。4)在术后化疗组中,将p53、c-erbB-2两项指标分为2项全阳性、2项全阴性、其中任1项阳性3组,3组生存率的差异具有显著性(P<0.05)。5)COX多因素分析,提示组织学类型、p53、c-erbB-2是影响术后化疗效果的独立指标。结论:p53、c-erbB-2、VEGF蛋白表达是预后较差的指标之一,预测p53、c-erbB-2蛋白表达阳性者较阴性者对化疗不敏感,将p53、c-erbB-2。Objective:The aim of this study is to determine the predictive value of p53,c-erbB -2and VEGF expression in adjuvant chemotherapy of non-small cell lung cancer (NSCLC).Methods:Expression of p53,c-erbB-2and VEGF in18patients with NSCLC who received radi -cal surgery and cisplatin -based chemotherapy were d etermined by LSAB immunohistochemical method in contrast with15NSCLC patients received surgery alone.Kaplan-Meier method and Cox proportional hazard model w ere used to analyze the correlation of their expression with prog-nosis and pre dictive value in chemotherapy.Results:1)The positive rate of p53,c-erbB -2were54.7%and47.17%,respectively,and there was significant surv ival difference between the positive patients and negative ones and in surgery alone and surgery plus chem otherapy group patients． ２）The positive rate of V E G F w as ５４．７２％，and there w as significant difference in single surgery group，but no significant difference in surgery plus chem otherapy group．３）In the single surgery group，the patients＇expression of p５３，c－erbB －２，V E G F w ere subdivided into three groups （all positive，all negative and one or tw o of them positive）there show ed significant survival difference betw een these three subgroups．４）The expression of p５３，c－erbB －２in the patients w ho had post－ operative chem otherapy w ere subdivided into three groups （all positive，all negative and either of them positive），there show ed significant survival difference betw een these three subgroups．５）C ox＇s m odel show ed that the histologic subtype，c－erbB －２，p５３ had separate and significant im pacts on prognosis in surgery plus chem otherapy group．C onclusion：O verexpression of p５３，c－erbB －２， V E G F protein predict poor prognosis，and overexpression of p５３，c－erbB －２ have the tendency of resisting to chem otherapy．C om bined detection of p５３，V E G F and c－erbB －２ expression m ay be of predictive valu

关 键 词：非小细胞肺癌 辅助化疗 p53蛋白 C-ERBB-2蛋白 VEGF蛋白 免疫组化 

分 类 号：R734.2[医药卫生—肿瘤]