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目的:探讨小细胞肺癌组织中羧酸酯酶-2(CES-2)和拓扑异构酶1(topo1)的表达对伊立替康(CPT-11)联合铂类化疗预后的临床意义。方法:分别应用免疫组化方法和酶联免疫吸附方法检测接受CPT-11联合铂类治疗的48例小细胞肺癌患者组织CES-2表达和topo1活性,并与患者化疗的临床预后如无疾病进展期(PFS)和总生存期(OS)进行比较。结果:48例小细胞肺癌标本中,CES-2阳性比为72.9%,topo1活性为(22 459±5 422)U·mg-1protein,CES-2表达及topo1活性在不同分期小细胞肺癌患者中差异均无统计学意义(P>0.05)。不同分期小细胞肺癌患者CES-2是否表达与其中位PFS及OS差异亦均无统计学意义(P>0.05)。31例局限期小细胞肺癌患者中,CES-2表达阳性的中位PFS及OS分别是12.3,18个月;CES-2表达阴性的中位PFS及OS分别是10.9,17.6个月。17例广泛期小细胞肺癌患者中,CES-2表达阳性的中位PFS及OS分别是10.5,14.1个月;CES-2表达阴性的中位PFS及OS分别是10.2,13.8个月。结论:CES-2表达和topo1活性尚不足以预测CPT-11联合铂类治疗小细胞肺癌的预后,有待扩大样本量进一步从疗效、毒性及预后方面同时考察。
Objective: To investigate the clinical significance of the expression of carboxylesterase-2 (CES-2) and topoisomerase 1 (topo1) in small cell lung cancer (NSCLC) in patients with irinotecan (CPT-11) combined with platinum-based chemotherapy. METHODS: CES-2 expression and topo1 activity in 48 cases of small cell lung cancer treated with CPT-11 combined with platinum were detected by immunohistochemical method and enzyme-linked immunosorbent assay, respectively, and the prognosis of the patients with chemotherapy was no disease progression. Period (PFS) and overall survival (OS) are compared. RESULTS: Of the 48 small cell lung cancer specimens, the positive rate of CES-2 was 72.9%, the activity of topo1 was (22 459±5 422) U·mg-1 protein, the expression of CES-2 and the activity of topo1 in patients with different stages of small cell lung cancer. The difference was not statistically significant (P>0.05). There was no significant difference in the expression of CES-2 between patients with different stages of small cell lung cancer and their median PFS and OS (P>0.05). Among the 31 patients with limited-stage SCLC, the median PFS and OS with positive CES-2 expression were 12.3 and 18 months, respectively; the median PFS and OS with negative CES-2 expression were 10.9 and 17.6 months, respectively. In 17 patients with extensive SCLC, the median PFS and OS with CES-2 expression were 10.5 and 14.1 months, respectively; the median PFS and OS with CES-2 negative expression were 10.2 and 13.8 months, respectively. CONCLUSIONS: CES-2 expression and topo1 activity are not sufficient to predict the prognosis of CPT-11 combined with platinum in the treatment of small cell lung cancer. It is necessary to expand the sample size to further investigate the efficacy, toxicity and prognosis.