中国癌症杂志 ›› 2020, Vol. 30 ›› Issue (11): 865-871.doi: 10.19401/j.cnki.1007-3639.2020.11.003

• 论著 • 上一篇    下一篇

BIM联合Scribble预测晚期非小细胞肺癌化疗效果

张龙富 1,2 ,姚家美 3 ,蒋冬先 3 ,侯英勇 3 ,张 新 2   

  1. 1. 上海市徐汇区中心医院呼吸科,上海 200031 ;
    2. 复旦大学附属中山医院呼吸科,上海 200032 ;
    3. 复旦大学附属中山医院病理科,上海 200032
  • 出版日期:2020-11-30 发布日期:2020-12-04
  • 通信作者: 张 新 E-mail: zhang.xin@zs-hospital.sh.cn
  • 基金资助:
    上海市医学重点专科建设计划(ZK2019C14)。

BIM combined with Scribble predicts treatment effect from chemotherapy in advanced non-small cell lung cancer

ZHANG Longfu 1,2 , YAO Jiamei 3 , JIANG Dongxian 3 , HOU Yingyong 3 , ZHANG Xin   

  1. 1. Department of Pulmonary Medicine, Central Hospital of Xuhui District, Shanghai 200031, China; 2. Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China; 3. Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
  • Published:2020-11-30 Online:2020-12-04
  • Contact: ZHANG Xin E-mail: zhang.xin@zs-hospital.sh.cn

摘要: 背景与目的:BIM基因和Scribble均是参与细胞凋亡的重要介质。BIM基因的BH3域缺失,可引起凋亡受阻。Scribble低表达对肿瘤细胞增殖、肿瘤转移和耐药有促进作用。通过检测BIM基因多态性和Scribble表达,探讨其与晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)化疗效果的关系。方法:收集2014年1月—2015年12月于复旦大学附属中山医院就诊的96例晚期NSCLC患者,所有患者均一线接受含铂方案化疗。采用聚合酶链反应(polymerase chain reaction,PCR)检测NSCLC患者组织标本中的BIM基因多态性,采用免疫组织化学法检测标本中的Scribble表达水平,然后评估BIM基因多态性和Scribble表达与化疗疗效的关系。结果:BIM基因野生型组化疗的中位无进展生存期(progression-free survival,PFS)优于BIM基因缺失组(5.0个月 vs 2.7个月,P=0.01)。Scribble高表达组化疗的中位PFS优于Scribble低表达组(7.0个月 vs 4.0个月,P<0.001)。BIM基因野生型且Scribble高表达组(BIM-WT-Scrib-H)化疗的中位PFS优于BIM基因野生型或Scribble高表达组(BIM-WT/Scrib-H)和BIM基因缺失型且Scribble低表达组(BIM-del-Scrib-L)(10.0个月 vs 4.5个月 vs 2.0个月,P<0.001)。多因素分析结果显示,BIM基因缺失型为化疗具有更短PFS的独立预测因素(HR=3.221,P<0.001);Scribble低表达为化疗具有更短PFS的独立预测因素(HR=3.312,P<0.001)。结论:BIM基因缺失型和Scribble低表达是晚期NSCLC化疗效果不佳的独立预测因素,两者联合应用有更好的预测价值。

关键词: BIM基因, Scribble, 非小细胞肺癌, 化疗

Abstract: Background and purpose:BIM gene and Scribble are important mediators involved in cell death. BIM isoform without BH3-only domain blocks apoptosis in cancer cells. Deregulated Scribble expression contributes to tumorigenesis including proliferation, invasion, metastasis and drug resistance in various epithelial cancers. We explored the impacts of BIM polymorphism and Scribble expression on treatment effect of advanced non-small cell lung cancer (NSCLC) with chemotherapy. Methods: Ninety-six patients with advanced NSCLC who received platinum-based chemotherapy in Zhongshan Hospital, Fudan University from Jan. 2014 to Dec. 2015 were enrolled. Polymerase chain reaction (PCR) was used to detect BIM gene polymorphism in NSCLC patients. Immunohistochemistry was used to detect the expression level of Scribble in specimens. BIM gene polymorphism and Scribble expression were correlated with treatment outcome from chemotherapy. Results: Among patients who received chemotherapy, the median progression-free survival (PFS) were 5.0 and 2.7 months for patients with wild-type BIM gene and BIM gene deletion polymorphism, respectively (P=0.010). Patients with Scribble high expression had significantly longer median PFS than those with Scribble low expression (7.0 months vs 4.0 months, P<0.001). Patients with wild-type BIM gene and Scribble high expression had significantly longer median PFS than those with wild-type BIM gene or Scribble high expression, and those with BIM gene deletion polymorphism and Scribble low expression (10.0 months vs 4.5 months vs 2.0 months, P<0.001). Multivariate analysis showed that BIM gene deletion and Scribble low expression were independent indicators of shorter PFS (HR=3.221, P<0.001; HR=3.312, P<0.001). Conclusion: BIM gene deletion and Scribble low expression predict shorter PFS to chemotherapy. BIM combined with Scribble have better predictive value.

Key words: BIM Gene, Scribble, Non-small cell lung cancer, Chemotherapy