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1. 南方医科大学研究生学院,广州,510515
2. 广州医学院第一附属医院胸外科广州呼吸疾病研究所,广州,510120
纸质出版日期:2012,
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赵美玲, 杨海虹, 张亚雷, 等. Ⅱb/Ⅲa期非小细胞肺癌患者肿瘤RRM1蛋白的表达意义[J]. 重庆医科大学学报, 2012,37(8):698-702.
ZHAO Meiling, YANG Haihong, ZHANG Yalei, et al. Expression and clinical significance of RRM1 protein in non-small cell lung cancer at stage of Ⅱb/Ⅲa[J]. Journal of Chongqing Medical University, 2012,37(8):698-702.
赵美玲, 杨海虹, 张亚雷, 等. Ⅱb/Ⅲa期非小细胞肺癌患者肿瘤RRM1蛋白的表达意义[J]. 重庆医科大学学报, 2012,37(8):698-702. DOI:
ZHAO Meiling, YANG Haihong, ZHANG Yalei, et al. Expression and clinical significance of RRM1 protein in non-small cell lung cancer at stage of Ⅱb/Ⅲa[J]. Journal of Chongqing Medical University, 2012,37(8):698-702. DOI:
目的:研究核苷酸还原酶M1亚基(Ribonucleotide reductase subunit M1,RRM1)蛋白在Ⅱb/Ⅲa期非小细胞肺癌(Non-small cell lung cancer,NSCLC)术后患者中的表达及RRM1蛋白表达对辅助化疗无疾病生存期(Disease free survival,DFS)的影响。方法:采用链霉菌抗生物素蛋白-过氧化酶染色(Streptavidin-perosidase,SP)法回顾性检测100例Ⅱb/Ⅲa期NSCLC根治术后患者肿瘤组织RRM1蛋白表达,分析其表达状况与患者临床特征之间的关系,并使用SPSS 13.0进行统计,研究分析其对患者预后的影响。结果:(1)RRM1蛋白在不同的性别、吸烟状况、分化程度、病理分期及不同治疗组中表达无明显差异(P >0.05),RRM1蛋白表达在鳞癌患者中高于非鳞癌患者,但无统计学差异(44.1%/30.3%,P=0.172);(2)在入组患者中,RRM1蛋白低表达较RRM1蛋白高表达患者DFS时间明显延长(中位时间,14月/8月,P=0.019 4);(3)亚组分析中,吉西他滨/顺铂方案辅助化疗组,鳞癌患者较非鳞癌患者DFS时间明显延长(中位时间,14月/11月,P=0.011 9);接受吉西他滨/顺铂方案辅助化疗组的患者中,RRM1蛋白低表达患者DFS较高表达患者明显延长(中位时间,13月/6月,P=0.021 7),但在单纯接受手术组的患者中不同RRM1蛋白表达的患者中DFS无明显差异(中位时间,15.5月/13月,P >0.05);(4)COX多因素分析显示只有RRMl蛋白表达和病理类型是Ⅱb/Ⅲa期NSCLC的独立影响因素(P均<0.005)。结论:在Ⅱb/Ⅲa 期NSCLC患者中,RRM1蛋白可能是患者吉西他滨/顺铂辅助化疗方案疗效的预测因子。
Objective:To investigate the postoperative expression of ribonucleotide reductase subunit M1(RRM1) protein in non-small cell lung cancer(NSCLC) at stage of Ⅱ b/Ⅲ and to discuss the effect of RRM1 protein expression on disease free survival(DFS) of patients underwent adjuvant chemotherapy. Methods:Totally 100 patients with NSCLC at stage of Ⅱb/Ⅲa who underwent radical surgery were included in this study. The expression of RRM1 protein in tumor specimens was assayed by streptavidin-perosidase(SP)immunohistochemistry retrospectively. Correlations between the expression of RRM1 protein and the clinical features or DFS time af-ter operation were analyzed. SPSS 13.0 was used to analyze the effect of RRM1 protein expression on the patients’ prognosis. Results:(1)No difference in the expression of RRM1 protein was found among patients with different genders,ages,smoking habits,patho-logical differentiation and stages(P>0.05). RRM1 protein expression was increased in squamous carcinoma than in non-squamous car-cinoma although there was no significant difference(44.1% vs. 30.3%,P=0.172);(2)Patients with lower RRM1 protein expression ex-perienced longer DFS time compared with those with higher RRM1 protein expression(median DFS,14 months vs. 8 months,P=0.019 4);(3)In patients with adjuvant chemotherapy of Gemcitabine/Cisplatin,squamous carcinoma led to longer DFS time than non squamous carcinoma(median DFS,14 months vs. 11 months,P=0.011 9);lower RRM1 protein expression led to longer DFS time than higher RRM1 protein expression(median DFS,13 months vs. 6 months,P=0.021 7). No difference in the length of DFS time was found in the patients with only surgery(median DFS,15.5 months vs. 13 months,P >0.05). (4)COX multivariate regression analysis showed that the expression of RRM1 protein and pathological type were the independent prognostic factors of DFS in NSCLC at stage of Ⅱb/Ⅲa. Conclusion:RRM1 protein is a valuable predictive factor for Gemcitabine/Cisplatin adjuvant chemotherapy in NSCLC at stage of Ⅱb/Ⅲa.
Ⅱb/Ⅲa期非小细胞肺癌术后辅助化疗吉西他滨核苷酸还原酶M1亚基蛋白免疫组化
stage of Ⅱb/Ⅲanon-small cell lung cancer(NSCLC)postoperative adjuvant chemotherapygemcitabineribonucleotide reductase subunit M1(RRM1)immunohistochemistry
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