非小细胞肺癌组织中MMP12、HMGB1的表达及其临床意义

目的：研究非小细胞肺癌中人巨噬细胞金属弹性蛋白酶（humanmacrophagemetalloelas-tase,HME,namelyMMP12）、高迁移率族蛋白B1（highmobilitygroupbox—B1,HMGB1）蛋白表达并探讨其与病理学分级、淋巴结转移等的关系,以及两者的相关性。方法：用免疫组化sP法分别检测53例非小细胞肺癌组织（其中肺鳞状细胞癌30例、肺腺癌23例）和20例癌旁组织中MMP12、HMGB1蛋白表达。结果：MMP12和HMGB1在非小细胞肺癌组织的阳性表达率分别为69．8％和5．4％,在癌旁组织中分别为15％和20％（P〈0．01）;肺鳞癌中MMP12阳性表达率86．6％高于腺癌组47．8％;MMP12和HMGB1表达在非小细胞肺癌中与淋巴结转移呈正相关（P〈0．05）;MMP12和HMGB1在非小细胞肺癌组织中表达成正相关（P〈0．01）。结论：MMP12和HMGB1可能在非小细胞肺癌患者的浸润、转移中起作用,联合检测有利于预后判断。     

晚期非小细胞肺癌ERCC1基因表达量的临界值研究及验证

目的 检测200例非小细胞肺癌FFPE样本中ERCC1的相对表达量,确定判别ERCC1表达量等级的临界值并对其进行回顾性验证.方法 采用实时荧光定量PCR技术检测FFPE样本中ERCC1和内参基因的表达量,并通过2-ΔCt法计算ERCC1的相对表达量.以其中位值为判别ERCC1表达量等级的临界值,并通过患者应用铂类化疗药物的短期、长期疗效进行回顾性验证.结果 200例FFPE样本中,ERCC1和内参基因均可检出的检出率为89.0％.ERCC1相对表达量与患者年龄、性别、分型、分期及有无吸烟史等差异均无显著性(P＞0.05).高表达、低表达ERCC1患者在应用药物后的客观有效率分别为22.0％、53.7％ (P ＜0.05).采用COX模型进行多因素回归分析,发现ERCC1表达量是影响患者无进展生存、总体生存的独立因素(P＜0.05).ERCC1高表达、低表达患者接受铂类化疗药物治疗的中位无进展生存时间分别为8个月、14个月,差异有显著性(P=0.018);ERCC1高表达、低表达患者中位总体生存时间分别为10个月、15个月,差异有显著性(P =0.028).结论 判定非小细胞肺癌ERCC1表达量等级的临界值适合进行后续验证,为相关检测标准的制定提供依据.     

非小细胞肺癌EGFR基因突变与ERCC1、RRM1、TUBB3 mRNA表达相关性研究

目的：探讨非小细胞肺癌(non-small cell lung cancer,NSCLC)患者表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变与切除修复交叉互补蛋白1(excision repair cross-complementation 1,ERCC1)、核苷酸还原酶亚单位M1(ribonucleotide reductase subunit M1,RRM1)及3型β-微管蛋白基因(classⅢβ-tubulin,TUBB3)表达的关系。方法：回顾性分析我院经病理诊断的69例NSCLC患者的手术切除的肿瘤标本,利用扩增受阻突变系统(amplification refractory mutation system,ARMS)进行EGFR基因突变检测,应用实时荧光定量PCR检测ERCC1、RRM1及TUBB3 mRNA的表达水平。结果：69例患者中,EGFR突变率为33.33%(23/69),在性别、吸烟史、病理类型组间突变率有显著性差异。ERCC1低、高表达率分别为59.42%(41/69)、40.58%(28/69),EGFR突变与ERCC1表达呈负相关性,EGFR无突变时ERCC1趋向于高表达(P=0.024);RRM1低、高表达率分别为31.88%(22/69)、68.12%(47/69),EGFR突变与RRM1表达无相关性(P>0.05);TUBB3低、高表达率分别为8.70%(6/69)、91.30%(63/69),EGFR突变与TUBB3表达无相关性(P>0.05)。ERCC1、RRM1、TUBB3三者间的基因表达均无相关性。结论：NSCLC患者肿瘤组织中EGFR突变患者ERCC1倾向低表达,这类患者可能更能从铂类化疗和靶向药物中受益。     

非小细胞肺癌中EGFR基因突变与ERCC1、Ki-67表达及临床病理特征的关系

目的：探讨非小细胞肺癌(non-small cell lung cancer, NSCLC)中EGFR基因突变与切除修复交叉互补基因1(excision re-pair cross-complementation group 1, ERCC1)、Ki-67蛋白表达及其临床意义。方法采用DNA测序法检测EGFR基因突变,免疫组化EnVision法检测ERCC1、Ki-67蛋白表达,分析与临床病理特征的关系。结果 EGFR 基因突变率为49．1%(143/291),多见于女性、不吸烟、腺癌患者。 EGFR基因突变在腺癌的不同亚型中差异有显著性(P=0．008);EGFR基因突变组肿瘤直径的中位数小于野生型组(P=0．020);EGFR基因突变与患者年龄、淋巴结有无癌转移无相关性(P>0．050);鳞状细胞癌中ERCC1阳性率高于腺癌(P=0．039)。 Ki-67表达与肺癌分化程度有关,低分化高于高、中分化(P=0．010);ERCC1、Ki-67表达与EGFR基因突变无相关性(P>0．050)。结论 EGFR基因突变与NSCLC患者性别、组织学类型、分化程度等相关,存在多种突变。 EGFR基因突变与ERCC1、Ki-67表达无相关性。     

急性白血病中MDR1 MRP和Fas表达及其临床意义

目的 研究多药耐药基因（MDR1）、多药耐药相关蛋白基因（MRP）和诱导凋亡的因子Fas在急性白血病（AL）的表达及它们与临床耐药的关系。方法采用流式细胞仪（FCM）直接免疫荧光法和半定量多聚酶链反应（RT-PCR）测定51例AL患者骨髓单个核细胞三种指标的表达情况。结果51例AL患者中MDR1／MRP／Fas三者共表达阳性率为11．76％，MDR1／MRP／Fas三者表达均阴性发生率为23．53％。三指标表达全阴性的患者75％获得完全缓解（CR），MDR^＋／MRP^＋／Fas^＋的患者84．21％获得CR，MDR^＋／MRP^＋／Fas^-或MDR^＋／MRP^＋无一人CR（P〈0．01）。单指标分析表明MDR1、MRP和Fas表达阳性率分别为21．15％、32．69％和65．38％。MDR1阳性者CR率18．18％，明显低于MDR1阴性者72．50％（P〈0．01）；MRP阳性者CR率29．41％，明显低于MRP阴性者76．47％（P〈0．01）；Fas阳性者CR率63．64％，略高于Fas阴性者55．56％，但二者无显著性差异。结论MDR1^＋／MRP^＋或MDR1^＋／MRP^＋／Fas^-者不易获CR，白血病患者的耐药除了与MDR1高表达密切相关外，还与非P^-糖蛋白（P-gp）介导的MRP及Fas表达等因素相关。     

窖蛋白-1在肺癌中的表达及意义

目的 探讨窖蛋白-1（caveolin-1）在不同类型肺癌组织中的表达及其与微血管密度（MVD）和临床病理因素之间的关系。方法 对154例原发性肺癌、相应癌旁正常肺组织及36例淋巴结转移癌行caveolin-1免疫组织化学染色;对154例原发性肺癌行CD34免疫组织化学（SP法）染色并进行微血管密度计数;Western印迹法检测其中50例新鲜肺癌组织及其癌旁正常肺组织中caveolin-1的表达情况。结果 caveolin-1为膜／质表达蛋白,在正常支气管上皮细胞和肺泡上皮细胞中的阳性率为100％。在肺癌组织中的阳性率为59．1％（91／154）,低于癌旁正常肺组织,P＜0．01;Western印迹结果进一步证实caveolin-1在肺鳞癌、肺腺癌组织中的表达均显著低于癌旁正常肺组织,P＜0．01。caveolin-1在小细胞肺癌（SCLC）和非小细胞肺癌（NSCLC）中的阳性率分别为7．1％和64．3％,二者间差异有统计学意义,P＜0．01。NSCLC中,有淋巴结转移组caveolin-1表达高于无淋巴结转移组（P=0．005）;Ⅲ、Ⅳ期组caveolin-1表达显著高于Ⅰ、Ⅱ期组（P=0．042）,caveolin-1表达与NSCLC的其他临床病理因素及MVD值无关（P＞0．05）。结论caveolin-1其作为一种肿瘤抑制因子的同时,可能还具有促进NSCLC进展和转移的活性。     

肺癌组织中MDR1mRNA、nm23H1mRNA、P—gp和CD446v6的表达及其相关性

目的：探讨肺癌组织中MDR1mRNA、nm23H1mRNA、P-gp和CD446v6的表达及其与淋巴结转移、病理分型的相关性。方法：应用原位杂交（ISH）CSA法和免疫组化EnVision法检测60例人原发性肺癌组织MDR1mRNA、nm23H1mRNA、P-gp和CD446v6的表达。结果：MDR1mRNA、nm23H1mRNA、P-gp混合单抗和CD44v6的阳性率分别为46．67％（28／60）、53．33％（32／60）、51．67％（31／60）和63．33％（38／60）。不同克隆P-gp阳性率分别为JSB－1 33．33％（20／60）,C219 31．70％（19／60）和C494 16．70％（10／60）。nm23H1mRNA与肺癌的第一站和第二站淋巴结转移呈负相关（P＜0．01,P＜0．05）,而CD44v6呈正相关（P＜0．01,P＜0．1）。MDR1mRNA和P-gp与CD44v6的阳性表达关系密切（P＜0．01,P＜0．06）,而CD44v6吴正相关（P＜0．01,P＜0．01）。MDR1mRNA、nm23H1mRNA、P-gp和CD446v6的阳性表达关系密切（P＜0．01）,并与肺癌患者吸烟关系密切（P＜0．01）。MDR1mRNA、nm23H1mRNA和P-gp的阳性符合率为80．64％（25／31）。结论：IHC方法检测P=pg能间接反映MDR1mRNA的转录水平,为准确评估肺癌病人对化疗的疗效提供一种有效手段,MDR的表达与病人吸烟关系密切。     

肺癌组织中突变型p53与Cox-2蛋白的相关性

目的探讨突变型p53和Cox-2蛋白在肺癌组织中表达的相关性及其对预后的影响。方法应用免疫组化SP法检测116例肺癌患者组织中突变型p53和Cox-2蛋白表达水平，并用CD34标记血管来计数肿瘤组织的微血管密度。结果116例肺癌中，突变型p53蛋白阳性47例（40．52％），Cox-2蛋白阳性78例（67．24％）。Cox-2蛋白的表达与肿瘤TNM分期（P=0．014）及其中的淋巴结转移情况（P=0．006）密切相关，且阳性表达的肺癌组织中微血管密度明显高于阴性表达者（P=0．000），有统计学意义。COX模型多因素分析显示，淋巴结的转移（P=0．004）和Cox-2蛋白的阳性表达（P=0．000）是肺癌患者的预后不良因素。结论突变型p53与Cox-2蛋白的表达有关，Cox-2可作为判断肺癌患者预后不良的潜在指标。     

三阴型乳腺癌中BRCA1的表达及其预后意义

目的：探讨乳腺癌易感基因1(breast cancer susceptibility gene 1, BRCA1)蛋白的表达及其对三阴型乳腺癌(triple nega-tive breast cancer, TNBC)患者预后的影响。方法采用免疫组化SP法检测95例TNBC组织蜡块中BRCA1、p53的表达,并结合患者临床病理特征进行相关性分析和预后评价。结果 TNBC中BRCA1的阳性率为31．6%,阳性患者中位年龄较阴性者明显偏小(P=0．047),且p53表达明显升高(P=0．001),阳性者与阴性者的总生存期差异无显著性(HR=1．110,95%CI=0．552~2．235,P=0．769)。结论 BRCA1蛋白表达与TNBC患者发病年龄、p53表达有关,但对患者的预后无明显影响。 p53通路与BRCA1表达在抑制肿瘤生长方面可能存在相关性。     

p21WAF1基因表达对人骨肉瘤预后的价值

目的 探讨骨肉瘤组织中p21^WAF1基因的表达与骨肉瘤生物学特性及预后的关系。方法 采用原位杂交及免疫组织化学（LSAB法）检测p21^WAF1mRNA及p21蛋白在45例骨肉瘤、10例骨纤维结构不良实体瘤组织标本的表达。结果 （1）p21蛋白阳性表达率在骨肉瘤中为17．7％（8／45）;（2）骨肉瘤组织高分化组与低分化组的p21蛋白阳性表达率之间的差异有统计学意义（40．0％,11．4％,X^2=4．34,P〈0．05）;（3）p21^WAF1mRNA表达阳性率在骨肉瘤中为42．2％（19／45）,骨肉瘤组织高分化组与低分化组的p21^WAF1mRNA阳性表达率之间的差异有统计学意义（60．0％,37．1％,X^2=20．6,P〈0．01）;（4）p21^WAF1mRNA表达阳性者术后生存时间高于表达阴性者术后生存时间（P〈0．05）。结论 （1）随着骨肉瘤恶性度的升高,p21^WAF1基因mRNA及p21蛋白的表达下降。（2）p21WAF1基因mRNA在骨肉瘤中的表达对评价患者的预后有一定价值。     

Excision repair cross-complementation group 1 (ERCC1) expression in advanced urothelial carcinoma patients receiving cisplatin-based chemotherapy

Cisplatin has been the cornerstone of the chemotherapy regimen for urothelial carcinoma. Excision repair cross-complementation group 1 (ERCC1) is a key component of the platinum-DNA repair machinery responsible for nucleotide excision repair. Recent reports have suggested that ERCC1 is a predictive and prognostic marker in solid cancers treated with platinum-based chemotherapy. We performed this study to determine whether or not immunohistochemical expression of ERCC1 can predict objective tumor response and cancer-specific survival in patients with advanced urothelial carcinoma treated with cisplatin-based chemotherapy. We performed a retrospective analysis of 89 patients with advanced or recurrent urothelial cancer, who had undergone treatment at Samsung Medical Center between May 2001 and August 2007. Pretherapeutic biopsy samples from 89 patients with a known tumor response were available. ERCC1 expression was assessed by immunohistochemistry. Of the 89 patients, ERCC1 expression was positive in 49 patients (55%). The overall response rate after chemotherapy was 68.5% (95% CI 54.8-74.8%). Among 61 patients who obtained a response, 27 were negative for ERCC-1 expression and 34 were positive (p = 0.61). Median duration of follow-up was 53.7 months (range 14.4-152.3 months). Progression-free survival (PFS) was 10.6 months for ERCC-1-negative patients and 8.4 months for ERCC-1-positive patients (p = 0.03); the difference in overall survival between patients with ERCC-1-negative tumors and ERCC-1-positive tumors (p = 0.73) was not statistically significant. Other than ERCC1 expression, there was no independent prognostic factor for PFS. These results suggest a negative contribution by ERCC1expression to PFS in metastatic urothelial carcinoma patients treated with cisplatin-based chemotherapy.     

The expression of ERCC1, RRM1, and BRCA1 in breast cancer according to the immunohistochemical phenotypes

We studied the expression of BRCA1, ERCC1, and RRM1 which play an important role in DNA repair systems in breast cancer. Immunohistochemical staining for EGFR, BRCA1, ERCC1, and RRM1 were performed by using a tissue microarray made from 230 breast cancer patients. Patients were classified into luminal A, luminal B, HER-2, and triple negative breast cancer (TNBC) types according to ER, PR, and HER-2 expression. The expression of ERCC1, RRM1, and BRCA1 were correlated (P < 0.05). The expression level of ERCC1 was the lowest in TNBC type (P = 0.031), ERCC1 negativity was more prominent in TNBC and luminal B groups than luminal A and HER-2 groups (P = 0.013). Cases with EGFR overexpression showed high expression of RRM1 and BRCA1 (P = 0.046, and 0.004, respectively). In conclusion, the expression of ERCC1 is particularly lower in TNBCs than other types of breast cancers.     

ERCC1 expression and tumor regression predict survival in esophageal squamous cell carcinoma patients receiving combined trimodality therapy

Purpose

Combined trimodality therapy with neoadjuvant chemoradiation followed by surgery has shown promising results for locally advanced operable esophageal cancer. DNA repair proteins may affect treatment efficacy through repairing DNA damage induced by chemotherapy and radiation therapy. We evaluated the associations of XRCC1, ERCC1 and MGMT expression with histopathologic response and survival in patients with locally advanced operable esophageal squamous cell carcinoma (ESCC) who received neoadjuvant chemoradiation.

Methods

Paraffin-embedded pre-treatment tissue samples, collected by endoscopic biopsy from patients treated with cisplatin-based neoadjuvant chemoradiation followed by surgery, were immunohistochemically stained for XRCC1, ERCC1 and MGMT expression.

Results

Of the 44 patients, major histopathologic response was noted in 26 (59.1%) patients. 68.8% of patients with ERCC1-negative tumors had major histopathologic response, compared to 53.6% of those who expressed positive ERCC1, though the difference was not statistically significant (P = 0.361). The patients with ERCC1-negative tumor presented much better overall survival than those positive for ERCC1 expression (P = 0.018). Patients with major histopathologic response had a 3-year survival rate of 96.2% versus those with minor response, with a 3-year survival rate of 41.5% (P = 0.000). Multivariate analysis showed that ERCC1 expression and histopathologic response were independent predictive factors of overall survival in patients with locally advanced operable ESCC receiving neoadjuvant chemoradiation.

Conclusion

Patients with ERCC1-negative tumors show a benefit from neoadjuvant chemoradiation, ERCC1 expression and tumor regression are useful predictive markers in patients with locally advanced operable ESCC receiving neoadjuvant chemoradiation followed by surgery.     

Polymorphisms in ERCC1 and XPF gene and response to chemotherapy and overall survival of non-small cell lung cancer

We conducted a perspective study to assess the association between ERCC1 and XPF polymorphisms and response to chemotherapy and clinical outcome of NSCLC receiving chemotherapy. Between May 2009 and May 2011, a prospective study was conducted on 240 NSCLC cases. Genotypes of ERCC1 (rs11615, rs3212986 and rs2298881) and XPF (rs2276465 and rs6498486) were performed by Polymerase Chain Reaction Restriction Fragment Length Polymorphism (PCR-RFLP) assay. By conditional logistic regression analysis, patients carrying AA genotype of ERCC1 rs11615 showed more CR+PR to chemotherapy when compared with GG genotype, and the adjusted OR (95% CI) was 2.73 (1.21-6.18). By Cox regression analysis, AA genotype of ERCC1 rs11615 was associated with longer overall survival of NSCLC, and the adjusted HR (95% CI) was 0.38 (0.14-0.96). In conclusion, our study found that ERCC1 rs11615 polymorphism can influence the chemotherapy response and overall survival of NSCLC patients receiving cisplatin-based chemotherapy.     

KEAP1 gene mutations and NRF2 activation are common in pulmonary papillary adenocarcinoma

Distinctive histological variants of lung cancer are increasingly recognized to have specific genetic changes that affect tumor biology and response to therapy. In this study, we evaluated true papillary adenocarcinoma of the lung, proposed as a distinct diagnostic category with relatively poor response to therapy, to determine whether these tumors also have specific molecular alterations that would affect sensitivity to chemotherapy. Specifically, we measured protein levels of P53, excision repair cross-complementation 1 (ERCC1) and ribonucleotide reductase M1 (RRM1) by immunohistochemistry and evaluated the Kelch-like erythroid cell-derived protein with cap-n-collar homology (ECH)-associated protein 1 (KEAP1) gene for mutations, correlating mutations of this gene with total and nuclear expression of the nuclear factor erythroid-2-related factor 2 (NRF2). We found high levels of P53 in 23 of the 55 specimens (41.8%), similar to the rate of P53 gene mutations observed in general for pulmonary adenocarcinoma, and levels of ERCC1 and RRM1 also showed distributions similar to those reported generally for non-small lung cell cancer (NSCLC). However, KEAP1 alterations were observed at a significantly higher frequency in papillary adenocarcinoma tumors (60%) than what has been reported previously for NSCLC (3-19%). These mutations of KEAP1 were associated with increased nuclear accumulation of NRF2 in tumors, as expected for functional alterations. Thus, high rates of KEAP1 mutations and NRF2 overexpression in true papillary adenocarcinoma could be related to poor prognosis and chemotherapy resistance. Furthermore, this distinctive molecular characteristic supports the recognition of true papillary adenocarcinoma as a diagnostic entity.     

非小细胞肺癌中窖蛋白1和pERK1/2表达与预后相关性研究

目的 探讨非小细胞肺癌(NSCLC)组织窖蛋白1与pERK1/2的表达及其与预后的关系.方法 应用免疫组织化学(sP法)检测160例NSCLC及20例正常肺组织标本中窖蛋白1与pERK1/2的表达.结果 窖蛋白1在NSCLC和正常肺组织阳性率分别为65.6%(105/160)和100%(20120),P=0.002.中-高分化组和低分化组阳性率分别为56.8%(46/81)和75.7%(53/70),P=0.015;Ⅰ-Ⅱ期阳性率为58.2%(53/91),Ⅲ-Ⅳ期阳性率75.4%(52/69),P=0.024;有淋巴结转移组阳性率为77.8%(56/72),无淋巴结转移组阳性率为55.7%(49/88),P=0.003.窖蛋白1阳性患者1、3、5年生存率(71.4%、37.1%、17.1%)低于阴性患者(89.1%、69.1%、43.6%),P=0.000.pERK1/2在NSCLC和正常肺组织阳性率分别为61.3%和0,P=0.000;中-高分化组和低分化组阳性率分别为53.1%(43/81)和71.4%(50/70),P=0.021;Ⅰ-Ⅱ期阳性率为49.5%(45/91),Ⅲ-Ⅳ期阳性率76.8%(53/69),P=0.000;有淋巴结转移组阳性率为80.6%(58/72),无淋巴结转移组阳性率为45.5%(40/88),P=0.000.pEBK1/2阳性患者1、3、5年生存率(74.5%、42.9%、19.4%)低于阴性者(82.3%、56.5%、37.1%),P=0.002.窖蛋白1与pERK1/2负相关,P=0.000.结论 窖蛋白1在NSCLC中低表达,pEBK1/2在NSCLC中高表达.窖蛋白1蛋白阳性表达和pEBK1/2蛋白高表达与NSCLC的发生及侵袭、转移相关.窖蛋白1和pERK1/2可作为NSCLC一个预后预测的指标.     

Bridging integrator 1在胃腺癌中的表达及其预后价值

目的研究Bridging integrator 1（BIN1）在胃腺癌中的表达及其预后价值。方法通过免疫组化研究BIN1在234个胃腺癌组织样本中的表达,之后运用荧光定量PCR（RT-qPCR）和蛋白质印迹（Western blotting）技术对免疫组化结果进行进一步验证。结果通过免疫组化数据表明,在234个胃腺癌病例中,有128例的BIN1表达水平下降（54.7%）。此外,BIN1的表达水平与组织学分级、肿瘤侵袭、淋巴结转移及TNM分期显著相关（P〈0.05）。通过RT-qPCR和Western blotting分析,发现与非胃腺癌组织相比较,大多数肿瘤组织中的BIN1的转录和转录后水平下调（P=0.0015和P=0.012）。Kaplan-Meier存活曲线证实BIN1表达水平的下降与胃腺癌患者的预后不良有关。进一步的多因素分析结果提示BIN1是胃腺癌患者的总存活率的独立预后因子（HR=0.552,95%CI：0.354～0.862,P=0.009）。结论在胃腺癌中BIN1表达的下降可导致疾病预后不良,BIN1作为潜在的肿瘤抑制基因可能在防止肿瘤进展方面起重要作用。     

PTEN和NDRG1在子宫内膜癌中的表达及意义

目的探讨PTEN和NDRG1蛋白的异常表达在子宫内膜癌发生、侵袭和转移中的作用及意义。方法采用免疫组织化学方法检测124例I型子宫内膜癌、28例内膜不典型增生、35例正常内膜组织中PTEN和NDRG1的表达,结合临床病理因素进行分析。结果PTEN和NDRG1在子宫内膜癌中的阳性表达率分别为29．18％、52．14％,与正常内膜组和不典型增生组比较,差异均有统计学意义（P〈0．05）。PTEN表达下调或NDRG1过度表达与肿瘤分化程度明显相关（P〈0．05）。结论PTEN的表达缺失或NDRG1蛋白的高表达,在子宫内膜癌发生、侵袭和转移中起重要作用,故而在临床中检测PTEN和NDRG1的表达,对于判断子宫内膜癌的恶性程度和预后有重要意义。     

伊立替康或多西他赛联合奥沙利铂治疗晚期非小细胞肺癌的临床观察

目的：观察伊立替康或多西他赛联合奥沙利铂治疗晚期非小细胞肺癌（NSCLC）的近期疗效及毒副作用。方法1晚期非小细胞肺癌68例中,伊立替康联合奥沙利铂组（A组）36例,采用伊立替康100mg／m2,第1、8天;奥沙利铂130mg／m2,第2天,静脉滴注。多西他赛联合奥沙利铂组（B组）32例,采用多西他赛75mg／m2,第1天;奥沙利铂130mg／m2,第2天,静脉滴注。21天为1周期,连用2周期后评定疗效。结果：A组和B组有效率分别为41．67％和31．25％,两组差异无统计学意义（P〉0．05）。A组迟发性腹泻和胆碱性综合征发生率明显高于B组（P〈0．01）,但A组粒细胞减少发生率明显低于B组（P〈0．05）。结论：伊立替康或多西他赛联合奥沙利铂治疗晚期非小细胞肺癌有较好的疗效,不良反应可以耐受,安全性好,可以考虑作为晚期非小细胞肺癌治疗方案之一。