晚期非小细胞肺癌患者血清细胞因子水平与厄洛替尼治疗疗效相关性.docVIP

晚期非小细胞肺癌患者血清细胞因子水平与厄洛替尼疗效相关性的研究 刘 璐，王永生，何雅億，任胜祥，李爱武，李雪飞，陈晓霞，戚 川，周彩存 （200433上海，同济大学附属上海市肺科医院肿瘤科，同济大学医学院肿瘤研究所） [摘要] 目的 探讨晚期非小细胞肺癌（non- small cell lung cancer, NSCLC）患者血清细胞因子水平与厄洛替尼疗效的相关性。方法 入组二线/三线接受厄洛替尼治疗的晚期NSCLC患者162例。收集厄洛替尼治疗前的血样，采用酶联免疫吸附法(enzyme-linked immunosorbent assay, ELISA)测定血清中IL-1, IL-2R, IL-6及TNF-α的表达水平。采用Kaplan–Meier生存分析法对入组病例进行生存时间分析，Cox回归多因素分析法对细胞因子水平、病例临床特征与疾病进展时间（time to progression, TTP）及总生存时间（overall survival, OS）的相关性进行分析。结果 收集2007年1月至2011年5月同济大学附属上海市肺科医院162例晚期非小细胞肺癌患者入组。入组病例中位年龄为58岁。其中男性109例，女性53例；既往吸烟或未戒烟者74例，不吸烟者88例；病理类型为腺癌122例，鳞癌27例，其他类型13例；ECOG体力状态评分0～1分的病例139例，2～3分23例。在多因素分析结果中，IL-1、IL-2R和IL-6的表达水平与年龄、性别、ECOG体力状态评分、吸烟状态、病例类型及肿瘤分期无明显相关性，而TNF-α的表达水平与吸烟状态相关（P=0.045）。生存分析结果显示，IL-6低表达的患者比IL-6高表达的患者有更长的生存期（P0.01），TNF-α低表达的患者较TNF-α高表达的患者有更长的生存期（P0.01）。Cox回归多因素分析结果显示，IL-6与TNF-α均为独立的生存相关的因子（P0.01）。结论 在二线/三线接受厄洛替尼治疗的晚期NSCLC中，IL-6、TNF-α低表达的患者生存期较高表达者长，提示IL-6和TNF-α可能成为厄洛替尼在晚期NSCLC中疗效的预测因子。 [关键词] [中图法分类号] [文献标志码] A Serum Cytokine Levels in Patients with Advanced Non-Small Cell Lung Cancer: Correlation with Clinical Outcome of Erlotinib Treatment Liu Lu，Wang Yongsheng，He Yayi, Ren Shengxiang，Li Aiwu，Li Xuefei，Chen Xiaoxia，Qi Chuan，Zhou Caicun（Shanghai Pulmonary Hospital affiliated to Tongji University, Oncology department, Oncology Institute of Tongji University Medical School,Shanghai,200433） [Abstract] Objective The aim of this study was to investigate the relationship of serum cytokine expression levels and the clinical outcome of erlotinib in a second or third line setting in patients with advanced non- small cell lung cancer (NSCLC).Methods 162 patients with advanced NSCLC who received erlotinib as either second or third line treatment were enrolled in this study. Blood samples were collected before the initiation of erlotinib, and the expression levels of IL-1, IL-2R, IL-6 and TNF-α were assessed by Enzyme-linked immunosorbent assay (ELISA). Cutoff points were defined as the median levels of IL-1 (low,