Derin Duygu, Soydinç Hilal Oguz, Guney Nese, Tas Faruk, Camlica Hakan, Duranyildiz Derya, Yasasever Vildan, Topuz Erkan
Institute of Oncology, Istanbul University, Istanbul, Turkey.
Lung Cancer. 2008 Feb;59(2):240-5. doi: 10.1016/j.lungcan.2007.08.005. Epub 2007 Sep 17.
This study was conducted to investigate the prognostic role and the effects of chemotherapy on serum apoptosis biomarkers consisting of survivin and tumor necrosis factor alpha (TNF-alpha) in patients with advanced stage nonsmall cell lung cancer (NSCLC).
Fifty-seven patients with newly diagnosed NSCLC were enrolled into study. Performance status was 0 or 1 in 47 patients and 2 in 10 patients. Thirty-two of them were no or less than 10% weight loss. Patients were treated with platinum-based chemotherapy. Serum levels of TNF-alpha and survivin were determined by enzyme-linked immunosorbent assay (ELISA) technique.
While serum survivin levels in patients were not significantly different from controls (p=0.321), serum TNF-alpha levels in patients were found significantly higher than in controls (p=0.029). We found that serum TNF-alpha levels were increased (p<0.001), whereas serum levels of survivin (p=0.025) were decreased by the chemotherapy effects. The changes of the TNF-alpha and survivin serum levels due to chemotherapy effect showed a significant negative correlation (r=-0.36 p=0.007). The increase of serum TNF-alpha levels was independent from chemotherapy response; however, the reduction of serum survivin levels was found only significant in the chemoresponsive group (p=0.039). While older age, weight loss and performance status yielded prognostic value, neither TNF-alpha nor survivin levels proved to be significant for survival.
Our findings suggest that the reduction in the serum survivin levels of advanced NSCLC patients after chemotherapy can be used as a predictor of response to the chemotherapy but not that of survival.
本研究旨在探讨晚期非小细胞肺癌（NSCLC）患者中，生存素和肿瘤坏死因子α（TNF-α）组成的血清凋亡生物标志物的预后作用及化疗效果。
57例新诊断的NSCLC患者纳入研究。47例患者的体能状态为0或1，10例患者为2。其中32例患者体重未减轻或减轻不超过10%。患者接受铂类化疗。采用酶联免疫吸附测定（ELISA）技术测定血清TNF-α和生存素水平。
患者血清生存素水平与对照组无显著差异（p = 0.321），而患者血清TNF-α水平显著高于对照组（p = 0.029）。我们发现化疗使血清TNF-α水平升高（p < 0.001），而血清生存素水平降低（p = 0.025）。化疗导致的TNF-α和生存素血清水平变化呈显著负相关（r = -0.36，p = 0.007）。血清TNF-α水平的升高与化疗反应无关；然而，血清生存素水平的降低仅在化疗反应组中显著（p = 0.039）。虽然年龄较大、体重减轻和体能状态具有预后价值，但TNF-α和生存素水平均未被证明对生存有显著意义。
我们的研究结果表明，晚期NSCLC患者化疗后血清生存素水平的降低可作为化疗反应的预测指标，但不能作为生存的预测指标。
