Junker K, Müller K-M, Bosse U, Klinke F, Heinecke A, Thomas M
Institut für Pathologie, Universitätsklinik Bergmannsheil, Bochum.
Pathologe. 2003 May;24(3):214-9. doi: 10.1007/s00292-002-0607-4. Epub 2003 Mar 13.
Dysregulation of apoptosis is closely associated with malignant cell transformation. On the other hand, apoptosis is induced by chemotherapy or irradiation. Therefore, in 54 patients with locally advanced non-small cell lung cancer (NSCLC, 36 squamous cell carcinomas, 18 adenocarcinomas, stage IIIA/IIIB), apoptotic indices were comparatively analysed before onset and after termination of neoadjuvant therapy. The results were compared with the response to neoadjuvant therapy (extent of therapy-induced tumour regression) as well as the survival times. A statistically significant difference could not be established between pre-therapeutically and post-surgically established apoptotic indices (mean values: 0.93% vs. 1.1%). Neither before therapy nor after surgery did the apoptotic indices show a significant predictive value concerning different overall survival times. These results suggest that neoadjuvant therapy does not modify the extent of apoptosis in lung cancer in the long term. Only a few weeks after the completion of the neoadjuvant chemoradiotherapy this contributes to a net proliferation of the residual tumour tissue which is largely equivalent to that of the untreated tumour.
细胞凋亡失调与恶性细胞转化密切相关。另一方面,细胞凋亡可由化疗或放疗诱导。因此,对54例局部晚期非小细胞肺癌(NSCLC,36例鳞状细胞癌,18例腺癌,IIIA/IIIB期)患者在新辅助治疗开始前和结束后进行了凋亡指数的比较分析。将结果与新辅助治疗的反应(治疗诱导的肿瘤消退程度)以及生存时间进行比较。治疗前和手术后确定的凋亡指数之间未发现统计学上的显著差异(平均值:0.93%对1.1%)。无论是治疗前还是手术后,凋亡指数均未显示出与不同总生存时间相关的显著预测价值。这些结果表明,新辅助治疗长期内不会改变肺癌细胞凋亡的程度。新辅助放化疗完成仅几周后,这会导致残余肿瘤组织的净增殖,其程度与未治疗的肿瘤大致相当。