Ekspresija p63 kao prediktivnog i prognostičkog faktora kod uznapredovalog nesitnoćelijskog karcinoma pluća
Sažetak
Apstrakt
Uvod/Cilj. Srbija se ubraja u grupu zemalja sa visokom incidencom i stopom mortaliteta od karcinoma pluća. Značajnu ulogu u nastanku karcinoma pluća ima gen p63. Imunohistohemijska ekspresija p63 je značajan marker za dijagnostiku skvamocelularnih carcinoma (SCK) pluća. Rezultati nekih in vitro istraživanja ukazuju na značajnu vezu ekspresije p63 i rezistencije na cisplatin. Cilj ovog istraživanja bio je da se proceni značaj ekspresije p63 kao prediktivnog i prognostičkog faktora kod uznapredovalog nesitnoćelijskog karcinoma pluća (NSĆKP). Metode. Imunohistohemijski je analizirana ekspresija p63 kod 85 NSĆKP pluća u III i IV stadijumu bolesti. Četiri nedelje nakon završetka 2 ciklusa hemioterapije na bazi platinskog dubleta vršena je procena odgovora na terapiju. Preživljavanje bez progresije bolesti i dužina preživljavanja izračunavani su primenom Kaplan-Meierove analize i log rang testa. Rezultati. Ekspresiju p63 imalo je 49,4% bolesnika. Pozitivnu ekspresiju (p63+) imalo je 38,8%, a slabu ekspresiju (p63+-) 10,6% bolesnika. Pozitivna ekspresija je ustanovljena kod 93,9% SCK, kod 5% adenokarcinoma (AC) i nijednog neklasifikovanog (NK) NSĆKP. Slaba ekspresija je nađena kod 12,5% AC, 25% NNS i kod 3% SCK. Analizom uticaja prisustva ekspresije p63 na inicijalni odgovor na hemioterapiju nije utvrdjena statistička značajnost. Bolesnici sa slabom ekspresijom p63 imali su značajno kraće vreme ukupnog preživljavanja u odnosu na bolesnike bez ekspresije p63 (p = 0.049) i tendenciju kraćeg vremena ukupnog preživljevanja u odnosu na bolesnike sa ekspresijom p63 (p = 0.068). Zaključak. Ovim istraživanjem ustanovljeno je da ekspresija p63 nema prediktivni značaj za odgovor na inicijalnu hemioterapiju po gemcitabin/cisplatin ili paklitaksel/cisplatin protokolu kod uznapredovalog NSĆKP. Slaba ekspresija p63 ima negativan prognostički značaj u III i IV stadijumu NSĆKP.
Reference
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