摘要
目的 :探讨ⅢA 期非小细胞肺癌 (NSCLC)的K ras基因突变对新辅助化疗的可能影响。方法 :确诊ⅢA 期NSCLC的 2 4例患者接受了 2个周期的新辅助化疗 ,然后手术 ;观察手术切除肿瘤标本的病理组织学反应 ,并采用PCR SSCP分析技术检测手术标本的K ras基因突变。结果 :化疗的临床有效率为 4 1.7% (10 / 2 4 )。手术切除率 95 .8% (2 3/ 2 4 ) ,完全性切除率 6 2 .5 % (15 / 2 4 )。化疗的组织学有效率为 4 3.5 % (10 / 2 3)。 2 3例手术切除标本中 9例 (31.9% )发生K ras基因突变。化疗后组织学有效患者的K ras基因突变率 (2 0 .0 % )明显低于组织学无效患者 (5 3.8% ,P <0 .0 5 ) ,获手术完全性切除的患者K ras基因突变率 (2 0 .0 % )显著低于手术不完全性切除患者 (75 .0 % ) (P <0 .0 5 )。结论 :新辅助化疗后组织学有效的患者K ras基因突变率低可能是化疗药物杀灭肿瘤细胞同时也消除了突变的K ras基因的结果 ,而不一定是K ras基因突变影响了新辅助化疗并进而影响患者的预后。
Objective: To investigate the impact of K-ras gene mutation in resection specimens on neoadjuvant chemotherapy in the patients with stage Ⅲ A non-small cell lung cancer (NSCLC). Methods: Twenty four patients with stage Ⅲ A NSCLC underwent treatment of operation after two cycles neoadjuvant chemotherapy. Pathohistological response in resection specimens was observed. Assessement of K-ras genes mutation in resection specimens was performed by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) analysis. Results:Clinical response rate of chemotherapy was 41 7% (10/24). Surgery resection rate was 95 8% (23/24). The rate of complete resection was 62 5% (15/24). Histological response rate of chemotherapy was 43 5% (10/23). Nine mutation (39 1%) of K-ras gene in resection specimens of twenty three patients were found. The rate of K-ras mutation (20 0%) in patients who had histological response for chemotherapy was significantly lower than those (53 8%) in patients without histological response (P<0 05). The rate of K-ras mutation was 20 0% in patients who had complete resection of tumor, as compared with 75 0% in patients who had incomplete resection of tumor (P<0 05). Conclusion:The lower rate of K-ras gene mutation in the patients who had histological response for chemotherapy may be a result of effective neoadjuvant chemotherapy, eliminating tumor compartments with mutation K-ras gene. The presence of K-ras gene mutation may be not of impact on the effect of neoadjuvant chemotherapy and patient prognosis. Further study of prognostic impact of K-ras gene mutation in resection specimens of the NSCLC patients with neoadjuvant chemotherapy is warranted.
出处
《临床肿瘤学杂志》
CAS
2004年第1期14-17,共4页
Chinese Clinical Oncology
