Park Tai Sun, Kim Hye-Ryoun, Koh Jae Soo, Jang Seung Hun, Hwang Yong Il, Yoon Ho Il, Chung Jin-Haeng, Kim Cheol Hyeon, Kim Sung-Soo, Kim Woo Sung, Jo Jungmin, Lee Jae Cheol, Choi Chang-Min
Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Republic of Korea.
Lung Cancer. 2014 Nov;86(2):262-7. doi: 10.1016/j.lungcan.2014.08.009. Epub 2014 Aug 22.
Although adjuvant platinum-based chemotherapy improves survival in completely resected non-small cell lung cancer (NSCLC), its effect is limited. We evaluated whether the expression of heat shock protein 70 (Hsp70) is associated with clinical outcomes in patients with completely resected NSCLC who were treated with or without adjuvant platinum-based chemotherapy.
Patients who underwent curative resection for NSCLC and diagnosed as stage IIA through IIIA were included. Immunohistochemical staining for Hsp70 was performed on surgical specimens and survival rates were compared by Hsp70 expression and adjuvant platinum-based chemotherapy.
Of 327 enrolled patients, Hsp70 expression was positive in 220 (67.3%). For patients who did not receive adjuvant chemotherapy, Hsp70 expression did not significantly affect survival. However, for patients who received adjuvant chemotherapy, those with Hsp70-positive tumors had a longer disease-free survival outcome than cases with Hsp70-negative tumors (not reached vs. 27.3 months; P=0.002), although there was no significant difference in overall survival (97.0 vs. 58.9 months, P=0.080). In the adjuvant chemotherapy group, multivariate modeling showed that patients with Hsp70-postitive tumors had a lower risk of recurrence and death after adjusting for age, sex, performance status, pathologic stage, and histological type (disease-free survival: adjusted hazard ratio, 0.537; 95% CI, 0.362-0.796; P=0.002; overall survival: adjusted hazard ratio, 0.663; 95% CI, 0.419-1.051; P=0.080).
Hsp70 is a positive predictive factor in completely resected NSCLC with received platinum-based adjuvant chemotherapy.
尽管辅助性铂类化疗可提高完全切除的非小细胞肺癌（NSCLC）患者的生存率，但其效果有限。我们评估了热休克蛋白70（Hsp70）的表达与接受或未接受辅助性铂类化疗的完全切除NSCLC患者临床结局之间的相关性。
纳入接受NSCLC根治性切除且诊断为IIA期至IIIA期的患者。对手术标本进行Hsp70免疫组织化学染色，并根据Hsp70表达情况和辅助性铂类化疗比较生存率。
在327例入组患者中，220例（67.3%）Hsp70表达呈阳性。对于未接受辅助化疗的患者，Hsp70表达对生存率无显著影响。然而，对于接受辅助化疗的患者，Hsp70阳性肿瘤患者的无病生存结局优于Hsp70阴性肿瘤患者（未达到 vs. 27.3个月；P=0.002），尽管总生存率无显著差异（97.0 vs. 58.9个月，P=0.080）。在辅助化疗组中，多因素模型显示，在调整年龄、性别、体能状态、病理分期和组织学类型后，Hsp70阳性肿瘤患者复发和死亡风险较低（无病生存：调整后风险比，0.537；95%CI，0.362-0.796；P=0.002；总生存：调整后风险比，0.663；95%CI，0.419-1.051；P=0.080）。
Hsp70是接受铂类辅助化疗的完全切除NSCLC的阳性预测因子。
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