Kaiser U, Schilli M, Haag U, Neumann K, Kreipe H, Kogan E, Havemann K
Zentrum Innere Medizin, Philipps-Universitat, Marburg, Germany.
Lung Cancer. 1996 Aug;15(1):31-40. doi: 10.1016/0169-5002(96)00568-5.
The expression of the proto-oncogene bcl-2, whose main function appears to be an inhibition of apoptosis, was investigated in 164 cases of primary small cell lung cancer by means of immunohistochemistry in a retrospective analysis. One-hundred twenty-five cases (76%) demonstrated expression of bcl-2. There was no difference in serum LDH levels and proliferative activity between the two groups. An analysis revealed a median survival time of 12 months for patients with bcl-2 positive tumors compared to 9.5 months for patients with bcl-2 negative tumors. Although statistical significance is not achieved, there is a trend towards longer survival in patients whose tumors express bcl-2. This tendency is also reflected by a higher rate of complete remission after chemotherapy: 40% in patients with bcl-2+ tumors versus 27% in patients with bcl-2- tumors. In multivariate analysis, tumor stage followed by Karnofsky index were the most valuable predictors for complete remission. LDH and tumor stage were most predictive for 1-year survival. Bcl-2 expression is frequent in SCLC and may reflect a less aggressive mechanism of transformation and a higher susceptibility to cytostatic treatment.
通过免疫组织化学方法对164例原发性小细胞肺癌进行回顾性分析，研究原癌基因bcl-2的表达，其主要功能似乎是抑制细胞凋亡。125例（76%）显示bcl-2表达。两组之间血清乳酸脱氢酶水平和增殖活性无差异。分析显示，bcl-2阳性肿瘤患者的中位生存时间为12个月，而bcl-2阴性肿瘤患者为9.5个月。尽管未达到统计学显著性，但肿瘤表达bcl-2的患者有生存时间更长的趋势。这种趋势也体现在化疗后完全缓解率较高：bcl-2阳性肿瘤患者为40%，而bcl-2阴性肿瘤患者为27%。在多变量分析中，肿瘤分期其次是卡诺夫斯基指数是完全缓解最有价值的预测指标。乳酸脱氢酶和肿瘤分期对1年生存率最具预测性。bcl-2表达在小细胞肺癌中很常见，可能反映了一种侵袭性较小的转化机制和对细胞抑制治疗的更高敏感性。
