文档介绍：查兰垦翌苎兰竺±堡壅兰兰竺笙查!竺壁
摘要
一^1匾构'外科手术治疗IIIA期非小细胞肺癌的效果很有限,而术后辅助治疗对总体生存无明显改善。多项研究表明,新辅助馋疗能够提高IliA期非小.、细胞肺癌的手术切除率和潜在延长生存期。才妍究旨在验证铂类制剂为基础
的新辅助化疗治疗IIIA期非小细胞肺癌的可行性和有效性。进~步通过研究新辅助化疗+手术和单纯手术患者的肿瘤凋亡相关蛋白、增殖和耐药指标的差异,探究新辅助化疗潜在延长肺癌患者生存率的内在机制。
f方法t我们对58例IIIA期非小细胞肺癌患者随机分组进行2周期的铂类崭辅助化疗后手术或单纯手术治疗,所有患者进行手术为主的多学科综合治疗。对化疗应答率、手术切除率和1年生存率进行评价。应用免疫组化方
法检测两组患者切除标本中凋亡相关基因p53、,增 A和耐药蛋白GST一7c的表达水平。
%。新辅助化疗组与单纯手术组相比有较高的手术切除率和1年生存率。p53蛋白的表达与化疗反应相关(p=)。p53蛋白的缺失和化疗后的淋巴结分期与新辅助化疗组患者的生存存在相关性,是预后指标。铂制剂为主的新辅助化疗组与单纯手术组比较,caspase一3和GST一Ⅱ蛋白的表达水平增高,PCNA蛋白的表达水平降低,。
结论t铂制剂为基础的新辅助化疗能够使IIIA期非小细胞肺癌局部肿瘤和淋巴结降期,提高手术切除率。新辅助化疗能最先控制全身潜在的微小转移灶,从而潜在延长无病生存和总体存活率。新辅助化疗通过诱导癌细胞凋亡和抑制增殖实现治疗作用,。,但是并没有产
生明显的继发性耐药。 X一.。,一”
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关键词;新辅助化疗;IliA期非小细胞肺癌;铂制剂为主;凋亡
堡主堡塞兰兰竺竺圭———————茎:!!!墨
Study on neoadjuvant chemotherapy for IIIA
non—small cell lung cancer
ABSTRACT
Objective:The efficacy ofsurgery for patients with stage IliA non—small cell lung cancer(NSCLC)is limited,and post—operative adjuvant therapy have no deftnitly improvement on survival till clinical studies suggested that neoadjuvant chemotherapy may improve the resectability and survival of IIIA conducted a randomized trial to examine the possible benefit of neoadjuvant chemother印y for the treatment of patients with IliA order to reveal the mechanism and potential role of neoadjuvant chemotherapy on examine the expressions of proteins associated、vitll apoptosis, proliferation and drug resistence of resected tumors of IIIA NSCLC patients received neoadjuvant chemotherapy plus surgery and surgery alone.
Methods:We studied 58 patients with IIIA patients were randomly assigned to received either surgery alone or two courses of platinum based neoadjuvant chemotherapy plus patients received multimodality therapy besides evaluated the chemotherapy response,
resection rate an