【摘要】 目的观察治疗前定量检测p53抗体对于晚期非小细胞肺癌的疗效和预后预测作用。方法 62例初治晚期NSCLC,治疗前采用p53定量分析试剂盒检测血清p53抗体量,治疗后临床密切观察。同时定量检测了30例健康人群血清的p53抗体作为对照。结果血清p53水平在30例健康人群中位数为0.77 IU/mL(0.60~1.07IU/mL),在62例初治晚期NSCLC中位数为1.75 IU/mL(0.61~12.00 IU/mL),差异有统计学意义(P<0.01);与患者血清CEA和CA125呈正相关(P<0.05),与CA242和CA153无相关性(P>0.05);非鳞癌显著高于鳞癌(P=0.01),不同性别和分期间差异无统计学意义(P>0.05);与化疗效果呈负相关,但差异无统计学意义(P=0.06);≥3.65者中位生存期8.5月,显著低于其余患者的18.9月(P=0.047)。多因素生存分析显示p53抗体升高和化疗后进展是独立的预后不良因素。结论晚期NSCLC患者血清p53抗体水平升高,有可能预测化疗效果,是独立的不良预后因素,可以作为晚期NSCLC个体化治疗的依据。更多还原

【Abstract】 Objective To explore the prognostic value of quantification of serum p53 antibody(p53-Ab) level in patients with advanced non-small cell lung cancer(NSCLC).Methods Serum samples were obtained from 60 patients with histologically confirmed advanced NSCLC and 30 healthy volunteers.The serum p53-Abs was quantitatively assessed by enzyme-linked immunosorbent assay.The patients with NSCLC were followed up intensively.Results The median p53-Abs level was 0.77 IU/mL(0.60~1.07 IU/mL) in the health volunteers and 1.75 IU/mL(0.61~12.00 IU/mL) in the patients with NSCLC.The difference was statistically significant.In patients with NSCLC,the p53-Abs level was positively correlated to the serum level of CEA and CA125(P<0.05),had no correlation with CA242 and CA153(P<0.05),was higher in non-squamous carcinoma than in others(P<0.05),and marginally correlated to chemoresistance(P=0.06).When p53-Ab level of 3.65 IU/mL was used as a cutoff point,the patients with elevated p53-Abs had significantly shortened overall survival(median OS: 8.5 months vs 18.9 months,P=0.047).Cox model showed that p53 level and chemo-ineffective were independent prognostic factors.Conclusions The serum p53-Ab level is related to NSCLC chemoresistance and an independent prognostic factor.Quantification of serum p53 Abs may help to tailor the treatment for advanced NSCLC.更多还原