肺腺癌C-erbB-2、p53表达与新辅助化疗有效性关系临床研究的初步报告

目的：观察肺腺癌c-erbB-2、p53表达与新辅助化疗有效性的关系。方法：2002年5月-2004年1月，我院经病理组织学确诊的肺腺癌患38例(其中低分化腺癌24例，中分化腺癌14例)，对其经石蜡包埋的肺癌组织标本采用免疫组化S-P法进行C-PrbB-2、p53蛋白表达的检测。对进入观察组的患，进行根治性放射治疗或手术前给予长春瑞滨加顺铂(NP)方案的化疗，长春瑞滨25mg／m^2，d1、d8，顺铂75mg／m^2,d，。每3周为1周期，3周期化疗后评价疗效。结果：未观察到p53表达阳性、C-erbB-2表达阳性与化疗疗效有密切关系(P=0．19，P=0．31)；但新辅助化疗有效率在C-erbB-2、p53表达均阳性为22．2％(2／9)，而在C-erhB-2、p53表达阴性为75．0％(9／12)，两比较差异有统计学意义(P=0．027)。未观察到C-erbB-2、p53表达与组织学分级的相关关系(P=0．44，P=0．42)。结论：肺腺癌患p53表达阳性、C-erbB-2表达阳性与化疗疗效无关；C-erhB-2、p53表达均阳性对治疗NSCLC常用的NP方案敏感性低于表达均阴性。因观察的例数尚少，最后的结论有待积累更多的病例。

The elementary report of a clinical study on the relationship between the expression of C-erbB-2 or p53 and the efficacy of the neuadjuvant chemotherapy in the patients with lung adenocarcinoma

Objective:To investigate the relation between the expression of C-erbB-2 or p53 and the efficacy of neuadjuvant chemotherapy in the patients with lung adenocarcinoma. Methods:From May. 2002 to Jan.2003, 38 patients with lung adenocarcinoma were eligible for our study, Of which 24 cases were low-differentiated adenocarcinoma and 14 cases were moderate-differentiated adenocarcinoma. Paraffinembedded specimens from the patients with lung adenocarcinoma were investigated by way of immunohistochemical S-P method to examine the expression of C-erbB-2 and p53. The patients enrolled in the study and received chemotherapy with the regimen of vinorelbine plus cisplatin before receiving radical radiotherapy or operation.Vinorelbine(25 mg/m~2,on day 1 and 8)and cisplatin(75mg/m~2, on day 3)were administered for one cycle, and repeated every 3 weeks. After 3 cycles of chemotherapy, the efficacy was evaluated for each patient according to the standard WHO criteria.Results:No relationship between the expression of C-erbB-2 or p53 and the chemotherapy efficacy was observed (P=0.19 and P=0.31, respectively). The response rate of neuadjuvant chemotherapy in the patients with both positive expression of C-erbB-2 and p53 was 75%(9/12),The difference of the response rates between these two groups was of significance statistically(P=0.027). No relation between the expression status of C-erbB-2 or p53 and the histological grading was found (P=0.44 and P=0.42,respectively).Conclusion:The positive expression of C-erbB-2 or p53 has no relation with the chemotherapy sensitivity in the patients with lung adenocarcinoma. The patients with expression of both C-erbB-2 and p53 had lower sensitivity to the chemotherapy with NP regimen, compared with those with no expression of both C-erbB-2 and p53. Because the number of the cases investigated was not large, further study is needed for the final conclusion.