Diez M, Pollán M, Maestro M, Torres A, Ortega D, Gómez A, Sánchez A, Hernando F, Balibrea J L
Department of General Surgery II, San Carlos University Hospital, Madrid, Spain.
Br J Cancer. 1997;75(5):684-9. doi: 10.1038/bjc.1997.122.
The concentration of c-erbB-2 oncogene-encoded protein (p185neu) in fresh tumour samples obtained at the time of surgery from 94 non-small-cell lung cancer patients (NSCLC) was determined by an enzyme immunoassay. The relative prognostic importance was estimated, and the influence of other predictors was assessed by means of a Cox's proportional regression model. Median concentration of p185 in tumour tissues was 206 U mg(-1) (range 21-1050 U mg(-1)). p185 level did not differ significantly among subgroups defined by TNM classification, histological type, sex and age. Categorization of patients by p185 level, with 206 U mg(-1) and 343 U mg(-1) taken as cut-off values (corresponding to the 50th and 80th percentiles of the frequency distribution), showed that the recurrence rate, cumulative disease-free likelihood at the 36-month follow-up and median time from surgery to the diagnosis of recurrence worsened progressively as the level of p185 increased. Multivariate analysis confirmed the independent prognostic value of p185 level. Risk of recurrence increased by 1.304 for every increase of 100 units in p185 concentration (95% CI 1.141-1.490) (P<0.001). These findings encourage the inclusion of p185 concentration assay in a future predictive multifactorial prognostic index in NSCLC.
采用酶免疫分析法测定了94例非小细胞肺癌(NSCLC)患者手术时获取的新鲜肿瘤样本中c-erbB-2癌基因编码蛋白(p185neu)的浓度。评估了其相对预后重要性,并通过Cox比例回归模型评估了其他预测因素的影响。肿瘤组织中p185的中位浓度为206 U mg(-1)(范围21 - 1050 U mg(-1))。p185水平在根据TNM分类、组织学类型、性别和年龄定义的亚组之间无显著差异。以206 U mg(-1)和343 U mg(-1)作为临界值(对应频率分布的第50和第80百分位数),根据p185水平对患者进行分类,结果显示,随着p185水平升高,复发率、36个月随访时的累积无病可能性以及从手术到复发诊断的中位时间逐渐恶化。多因素分析证实了p185水平的独立预后价值。p185浓度每增加100单位,复发风险增加1.304(95%可信区间1.141 - 1.490)(P<0.001)。这些发现促使在未来非小细胞肺癌的预测性多因素预后指数中纳入p185浓度检测。