Singhal Sunil, Vachani Anil, Antin-Ozerkis Danielle, Kaiser Larry R, Albelda Steven M
Section of Thoracic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Clin Cancer Res. 2005 Jun 1;11(11):3974-86. doi: 10.1158/1078-0432.CCR-04-2661.
Lung cancer is the leading cause of cancer death in the U.S. with survival restricted to a subset of those patients able to undergo surgical resection. However, even with surgery, recurrence rates range from 30% to 60%, depending on the pathologic stage. With the advent of partially effective, but potentially toxic adjuvant chemotherapy, it has become increasingly important to discover biomarkers that will identify those patients who have the highest likelihood of recurrence and who thus might benefit most from adjuvant chemotherapy. Hundreds of papers have appeared over the past several decades proposing a variety of molecular markers or proteins that may have prognostic significance in non-small cell lung cancer. This review analyzes the largest and most rigorous of these studies with the aim of compiling the most important prognostic markers in early stage non-small cell lung cancer. In this review, we focused on biomarkers primarily involved in one of three major pathways: cell cycle regulation, apoptosis, and angiogenesis. Although no single marker has yet been shown to be perfect in predicting patient outcome, a profile based on the best of these markers may prove useful in directing patient therapy. The markers with the strongest evidence as independent predictors of patient outcome include cyclin E, cyclin B1, p21, p27, p16, survivin, collagen XVIII, and vascular endothelial cell growth factor.
肺癌是美国癌症死亡的主要原因，其生存率仅限于能够接受手术切除的一部分患者。然而，即便进行了手术，复发率仍在30%至60%之间，这取决于病理分期。随着部分有效但可能有毒性的辅助化疗的出现，发现能够识别那些复发可能性最高、因而可能从辅助化疗中获益最大的患者的生物标志物变得越来越重要。在过去几十年里，出现了数百篇论文，提出了多种可能在非小细胞肺癌中具有预后意义的分子标志物或蛋白质。这篇综述分析了其中规模最大、最严谨的研究，目的是汇总早期非小细胞肺癌中最重要的预后标志物。在这篇综述中，我们主要关注主要涉及三大途径之一的生物标志物：细胞周期调控、细胞凋亡和血管生成。尽管尚未证明单一标志物在预测患者预后方面是完美的，但基于这些最佳标志物的概况可能在指导患者治疗方面有用。作为患者预后独立预测指标证据最充分的标志物包括细胞周期蛋白E、细胞周期蛋白B1、p21、p27、p16、生存素、ⅩⅧ型胶原蛋白和血管内皮细胞生长因子。
