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[目的]探讨Survivin、BRCA1及class Ⅲβ-tubulin蛋白在非小细胞肺癌(NSCLC)中的表达及与紫杉醇耐药的关系。[方法]应用免疫组织化学法检测64例NSCLC患者Survivin、BRCA1及class Ⅲβ-tubulin蛋白的表达;给予紫杉醇为基础的化疗方案,分析上述蛋白表达与紫杉醇化疗敏感性的关系。[结果]Survivin阳性与class Ⅲβ-tubulin阳性患者对紫杉醇方案治疗的有效率(RR)分别低于Survivin阴性患者(27.8%vs71.4%,P<0.05)与class Ⅲβ-tubulin阴性患者(23.5%vs73.3%,P<0.01);而BRCA1阳性患者对紫杉醇方案治疗的RR高于BRCA1阴性患者(60.0%vs31.0%,P<0.05)。多因素分析表明classⅢβ-tubulin是NSCLC紫杉醇治疗无进展生存期(PFS)的独立影响因素(χ2=4.852,P=0.027),分期是与总生存期(OS)相关的独立影响因素(χ2=4.105,P=0.035)。[结论]NSCLC患者Survivin、class Ⅲβ-tubulin蛋白表达阳性及BRCA1蛋白表达阴性预示对紫杉醇治疗相对不敏感。
[Objective] To investigate the expression of Survivin, BRCA1 and class Ⅲ β-tubulin protein in non-small cell lung cancer (NSCLC) and its relationship with paclitaxel resistance. [Method] The expression of Survivin, BRCA1 and class Ⅲβ-tubulin in 64 NSCLC patients was detected by immunohistochemistry. The paclitaxel-based chemotherapy regimen was used to analyze the relationship between the above protein expression and paclitaxel chemosensitivity. [Results] The response rates of paclitaxel regimen to Survivin positive and class Ⅲβ-tubulin positive patients were lower than those of Survivin negative patients (27.8% vs 71.4%, P <0.05) and class Ⅲβ-tubulin negative patients (23.5% vs 73.3%, P <0.01). However, RR of BRCA1-positive patients was higher than that of BRCA1-negative patients (60.0% vs31.0%, P <0.05). Multivariate analysis showed that class Ⅲβ-tubulin was an independent factor affecting the progression-free survival (PFS) of paclitaxel in NSCLC patients (χ2 = 4.852, P = 0.027). Staging was an independent predictor of overall survival (χ2 = 4.105 , P = 0.035). [Conclusion] The positive expression of Survivin and class Ⅲβ-tubulin protein in NSCLC patients and the negative expression of BRCA1 protein are relatively insensitive to paclitaxel treatment.