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MICA 表达对晚期非小细胞肺癌预后及 CIK 治疗疗效的影响。

Effects of MICA expression on the prognosis of advanced non-small cell lung cancer and the efficacy of CIK therapy.

机构信息

Department of Medical Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian Province, People's Republic of China.

出版信息

PLoS One. 2013 Jul 23;8(7):e69044. doi: 10.1371/journal.pone.0069044. Print 2013.

Abstract

OBJECTIVE

To investigate the clinical significance of the expression of MHC class I chain-related gene A (MICA) in patients with advanced non-small cell lung cancer and explore the relationship between MICA expression and the efficacy of cytokine-induced killer cell (CIK) therapy for treating advanced non-small cell lung cancer.

METHODS

We obtained data on 222 patients with advanced non-small cell lung cancer, including data on MICA expression, age, gender, ECOG score, pathological type, stage, treatment history (including 38 patients who were given autologous CIK cell infusion), and overall survival (OS). MICA expression in lung cancer tissue was evaluated by immunohistochemical staining. Analyses of MICA expression, and CIK therapy association with survival outcomes were performed using Cox proportional models, Kaplan-Meier methods, and the log-rank test.

RESULT

s MICA was expressed in both membrane and cytoplasm. MICA expression correlated with the stage of lung cancer, ECOG score, gender and age. Multivariate COX regression analysis showed that the expression of MICA was an independent prognostic factor of advanced non-small cell lung cancer (p = 0.002). In subgroup analysis, we divided the 222 patients into CIK and control groups. In the CIK group, the medium OS (mOS) of patients with a high expression of MICA was longer than in those with low expression of MICA (27 months vs. 13 months). In the control group, the mOS in patients with a high expression of MICA was shorter than in patients with low MICA expression (9 months vs. 18 months). COX regression analysis showed that the MICA expression affects the effect of CIK therapy (p<0.0001).

CONCLUSION

  1. The high expression of MICA is one of the indicators of a poor prognosis for advanced non-small cell lung cancer patients. 2) The high expression of MICA might be one of the predictive factors for successful CIK therapy.
摘要

目的

探讨人类白细胞抗原Ⅰ类链相关基因 A(MICA)在晚期非小细胞肺癌患者中的表达的临床意义,并探讨 MICA 表达与细胞因子诱导的杀伤细胞(CIK)治疗晚期非小细胞肺癌疗效的关系。

方法

本研究收集了 222 例晚期非小细胞肺癌患者的资料,包括 MICA 表达、年龄、性别、ECOG 评分、病理类型、分期、治疗史(包括 38 例接受自体 CIK 细胞输注的患者)和总生存期(OS)。采用免疫组化染色法检测肺癌组织中 MICA 的表达。采用 COX 比例风险模型、Kaplan-Meier 方法和对数秩检验分析 MICA 表达与生存结果的关系。

结果

MICA 在细胞膜和细胞质中均有表达。MICA 表达与肺癌分期、ECOG 评分、性别和年龄有关。多因素 COX 回归分析显示,MICA 表达是晚期非小细胞肺癌的独立预后因素(p=0.002)。亚组分析显示,222 例患者分为 CIK 组和对照组。在 CIK 组中,MICA 高表达患者的中位总生存期(mOS)长于低表达患者(27 个月比 13 个月)。在对照组中,MICA 高表达患者的 mOS 短于低 MICA 表达患者(9 个月比 18 个月)。COX 回归分析显示,MICA 表达影响 CIK 治疗的效果(p<0.0001)。

结论

1)MICA 的高表达是非小细胞肺癌患者预后不良的指标之一。2)MICA 的高表达可能是 CIK 治疗成功的预测因素之一。

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