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目的:通过检测核因子E2相关因子2(nuclear factor erythroid-2-related factor2,Nrf2)在晚期非小细胞肺癌中的表达情况,探讨其与一线含铂化疗方案疗效和患者预后的相关性。方法:回顾性分析接受一线含铂方案化疗的50例晚期非小细胞肺癌患者的临床资料,并采用免疫组织化学法检测所有患者组织标本中Nrf2的表达情况。应用SPSS17.0软件进行统计,分析Nrf2表达与一线含铂化疗方案的疗效与患者预后的相关性。结果:在晚期非小细胞肺癌患者中Nrf2的表达存在个体差异,总阳性率为34%(17/50);其中年龄≥70岁患者Nrf2的阳性率为58.3%(7/12),明显高于<70岁患者的26.3%(10/38)(P=0.041);发生远处转移患者中Nrf2阳性率为46.7%(14/30),明显高于无远处转移患者的15.0%(3/20)(P=0.021);Pearson相关分析表明,Nrf2表达与患者的年龄(r=0.370,P=0.020)、远处转移(r=0.289,P=0.042)、化疗疗效(r=0.315,P=0.026)、无进展生存期(progression free survival,PFS)(r=-0.393,P=0.006)及总生存期(overall survival,OS)(r=-0.309,P=0.029)均有相关性。COX多因素分析结果表明,Nrf2表达是一线含铂化疗方案疗效和PFS的独立预测因素(P<0.05)。结论:晚期非小细胞肺癌患者中Nrf2的表达是预测含铂方案疗效和PFS的独立预测因素,其有望成为临床上选择治疗非小细胞肺癌化疗方案的理想标志物。
OBJECTIVE: To investigate the expression of Nrf2 in advanced non-small cell lung cancer (NSCLC) by detecting its correlation with the efficacy of first-line platinum-based chemotherapy and its prognosis. Methods: The clinical data of 50 patients with advanced non-small cell lung cancer treated with first-line platinum-containing chemotherapy were retrospectively analyzed. The expression of Nrf2 in all the patients was detected by immunohistochemistry. Application SPSS17.0 software for statistical analysis of Nrf2 expression and first-line platinum-containing chemotherapy efficacy and prognosis of patients. Results: There was an individual difference in the expression of Nrf2 in patients with advanced non-small cell lung cancer, with a positive rate of 34% (17/50). The positive rate of Nrf2 in patients aged ≥70 years was 58.3% (7/12) The positive rate of Nrf2 in patients with distant metastasis was 46.7% (14/30), significantly higher than that of patients without distant metastasis (15.0%, 3%) (26.3%, 10/38) (P = 0.021) .Pearson correlation analysis showed that the expression of Nrf2 was positively correlated with age (r = 0.370, P = 0.020), distant metastasis P = 0.036), progression free survival (PFS) (r = -0.393, P = 0.006) and overall survival (OS = 0.309, P = 0.029) . COX multivariate analysis showed that Nrf2 expression was an independent predictor of efficacy and PFS in first-line platinum-based chemotherapy (P <0.05). Conclusion: The expression of Nrf2 in patients with advanced non-small cell lung cancer is an independent predictor of prognosis of platinum-containing regimen and PFS, which is expected to be an ideal marker for the clinical treatment of non-small cell lung cancer.