Predicting chemotherapy response to paclitaxel-based therapy in advanced non-small-cell lung cancer with P-glycoprotein expression
Predicting chemotherapy response to paclitaxel-based therapy in advanced non-small-cell lung cancer with P-glycoprotein expression
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DOI：
10.1159/000068411
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发表时间：
2003-01-01
期刊：
影响因子：
3.7
通讯作者：
Kao, A
中科院分区：
文献类型：
--
作者：
Yeh, JJ;Hsu, WH;Kao, A
背景：多药耐药基因1(MDR1)编码人P-糖蛋白(Pgp)，可能在肺癌的多药耐药中起重要作用。因此，在开始化疗前，准确判断肺癌组织中是否存在Pgp，以达到满意的化疗效果是非常重要的。目的：比较Pgp在非小细胞肺癌(NSCLC)中的表达及紫杉醇的治疗效果。方法：在紫杉醇化疗前，50例IIIb或IV期非小细胞肺癌患者进入本研究。对活检标本的多个不连续切片进行免疫组织化学分析，以确定Pgp的表达。在治疗结束后第3个月通过临床和放射学方法评价化疗效果。结果：反应良好的28例(100%)Pgp表达均为阴性，反应差的22例中15例(68%)Pgp表达阳性(p<；0.05)。其他预后因素(年龄、性别、体重减轻、表现状态、肿瘤细胞类型和肿瘤分期)在反应良好组和反应不良组之间没有发现显著差异。结论：虽然Pgp在非小细胞肺癌中的表达不能完全预测紫杉醇为主的化疗反应，但检测Pgp的表达将有助于为晚期非小细胞肺癌患者计划紫杉醇为主的治疗。为了证实我们的发现，有必要对更多的患者进行进一步的研究，并进行更长时间的随访。版权所有(C)2003 S.Karger AG，巴塞尔。
Background: It was reported that multidrug resistance gene 1 (MDR1) encoding human P-glycoprotein (Pgp) may play an important role in multidrug resistance of lung cancer. Therefore, before initiating chemotherapy, it is important to accurately determine the presence of Pgp in lung cancer, to achieve a satisfactory chemotherapy response. Objectives: The aim of this study was to compare immunohistochemical analyses of Pgp expression and response to paclitaxel in non-small-cell lung cancer (NSCLC). Methods: Before chemotherapy with paclitaxel, 50 patients with stage IIIb or IV NSCLC were enrolled in this study. Immunohistochemical analyses were performed on multiple nonconsecutive sections of the biopsy specimens to determine Pgp expression. Chemotherapy response was evaluated in the 3rd month after completion of treatment by clinical and radiological methods. Results: All of the 28 (100%) cases with good response had negative Pgp expression and 15 of the 22 (68%) cases with poor response had positive Pgp expression (p < 0.05). No significant differences were found for other prognostic factors (age, sex, body weight loss, performance status, tumor cell type, and tumor stage) between good response and poor response groups. Conclusions: Although Pgp expression in NSCLC does not fully predict chemotherapy response to paclitaxel-based therapy, detection of Pgp expression will aid in planning paclitaxel-based therapy for patients with advanced NSCLC. Further studies with a larger number of patients and a longer time of follow-up are necessary to confirm our findings. Copyright (C) 2003 S. Karger AG, Basel.