Nemunaitis J, Klemow S, Tong A, Courtney A, Johnston W, Mack M, Taylor W, Solano M, Stone M, Mallams J, Mues G
Texas Oncology, P.A., Dallas 75246, USA.
Am J Clin Oncol. 1998 Apr;21(2):155-60. doi: 10.1097/00000421-199804000-00013.
This trial was undertaken to determine the prognostic role of K-ras (p21), c-erb B-2 (p185) protein expression, and the presence or nonpresence of a K-ras gene mutation in patients with adenocarcinoma of the lung. This was a retrospective study of 103 patients with adeno- or large-cell carcinoma of the lung who had available paraffin-stored tumor material. The relation of several clinical variables to survival was analyzed. Immunohistochemical techniques were used to determine expression of p21 and p185. Polymerase chain reaction (PCR) and sequencing were used to determine K-ras mutation status. Tumor stage was the only nonmolecular clinical variable predictive of survival (p=0.0001). A combination of K-ras mutation and p 185 expression (p=0.0144), ras mutation and strong p21 expression (p=0.0137), and K-ras mutation and the combined expression of p21 and p185 were predictive of poor survival (p=0.0415) in univariate analysis of all patients. The sole presence of K-ras mutation was predictive of survival. Additionally, when combined with elevated p21 or p185 expression in a subset of patients with 4 or more years of follow-up, negative correlation with survival was observed.
本试验旨在确定K-ras（p21）、c-erb B-2（p185）蛋白表达以及K-ras基因突变的有无在肺腺癌患者中的预后作用。这是一项对103例肺腺癌或大细胞癌患者的回顾性研究，这些患者有石蜡包埋的肿瘤组织可用。分析了几个临床变量与生存的关系。采用免疫组织化学技术检测p21和p185的表达。采用聚合酶链反应（PCR）和测序检测K-ras突变状态。肿瘤分期是唯一可预测生存的非分子临床变量（p=0.0001）。在所有患者的单因素分析中，K-ras突变与p185表达的联合（p=0.0144）、ras突变与p21强表达的联合（p=0.0137）以及K-ras突变与p21和p185的联合表达可预测生存不良（p=0.0415）。单纯K-ras突变可预测生存。此外，在随访4年或更长时间的部分患者中，当与p21或p185表达升高相结合时，观察到与生存呈负相关。
