论文部分内容阅读
目的探讨非小细胞肺癌(NSCLC)患者在表皮生长因子受体(EGFR)抑制剂治疗发生耐药前后肺癌组织标本中B细胞淋巴瘤/白血病(bcl-2)表达的变化,明确bcl-2表达与EGFR抑制剂获得性耐药的关系。方法收集北京大学深圳医院2004年至2011年经吉非替尼片或盐酸厄洛替尼片治疗的23例NSCLC患者的系列肺癌组织标本。建立组织芯片,以免疫组化的方法检测bcl-2的表达情况,同时比较产生耐药前后bcl-2表达的变化。结果 23例标本耐药前bcl-2表达阳性例数为5例,阳性率为21.7%。耐药后bcl-2表达阳性例数为12例,阳性率为52.2%。两者比较,差异有统计学意义(X2=4.57,P=0.032)。表皮生长因子酪氨酸激酶抑制剂(EGFR-TKI)治疗后出现获得性耐药的患者,bcl-2较耐药前出现明显上调。结论 bcl-2介导的抗凋亡功能增强在EGFR-TKI获得性耐药的发生中可能起到了重要作用。
Objective To investigate the changes of bcl-2 expression in non-small cell lung cancer (NSCLC) patients before and after treatment with epidermal growth factor receptor (EGFR) inhibitors, and determine the expression of bcl-2 And EGFR inhibitor acquired resistance. Methods Twenty-three lung cancer specimens from 23 NSCLC patients treated with gefitinib or erlotinib hydrochloride tablets at Peking University Shenzhen Hospital from 2004 to 2011 were collected. Tissue microarray was constructed to detect the expression of bcl-2 by immunohistochemistry and to compare the changes of bcl-2 expression before and after drug resistance. Results The positive expression rate of bcl-2 in 23 cases before drug resistance was 5 cases, the positive rate was 21.7%. The number of bcl-2 positive cases after drug resistance was 12 cases, the positive rate was 52.2%. The difference between the two groups was statistically significant (X2 = 4.57, P = 0.032). In patients with acquired drug resistance after epidermal growth factor tyrosine kinase inhibitor (EGFR-TKI) treatment, bcl-2 was significantly up-regulated compared with that before drug resistance. Conclusion The enhanced anti-apoptotic function mediated by bcl-2 may play an important role in the acquired resistance of EGFR-TKI.