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Vojnosanitetski pregled
2018, vol. 75, br. 4, str. 366-373
jezik rada: engleski
vrsta rada: izvorni naučni članak
doi:10.2298/VSP160616220C

Creative Commons License 4.0
Ekspresija P63 kao prediktivnog i prognostičkog faktora kod uznapredovalog nesitnoćelijskog karcinoma pluća
aMilitary Medical Academy, Pulmonology Clinic, Belgrade + University of Belgrade, Faculty of Medicine of the Military Medical Academy, Belgrade
bUniversity of Belgrade, Faculty of Medicine of the Military Medical Academy, Belgrade
cUniversity of Belgrade, Faculty of Medicine of the Military Medical Academy, Belgrade + Institute for Pathology and Forensic Medicine, Belgrade
dInstitute for Pathology and Forensic Medicine, Belgrade
eMilitary Medical Academy, Pulmonology Clinic, Belgrade

e-adresa: goca3tc@yahoo.com

Sažetak

Srbija se ubraja u grupu zemalja sa visokom incidencom i stopom mortaliteta od karcinoma pluća. Značajnu ulogu u nastanku karcinoma pluća ima gen p63. Imunohistohemijska ekspresija p63 je značajan marker za dijagnostiku skvamocelularnih carcinoma (SCK) pluća. Rezultati nekih in vitro istraživanja ukazuju na značajnu vezu ekspresije p63 i rezistencije na cisplatin. Cilj ovog istraživanja bio je da se proceni značaj ekspresije p63 kao prediktivnog i prognostičkog faktora kod uznapredovalog nesitnoćelijskog karcinoma pluća (NSĆKP). Metode. Imunohistohemijski je analizirana ekspresija p63 kod 85 NSĆKP pluća u III i IV stadijumu bolesti. Četiri nedelje nakon završetka 2 ciklusa hemioterapije na bazi platinskog dubleta vršena je procena odgovora na terapiju. Preživljavanje bez progresije bolesti i dužina preživljavanja izračunavani su primenom Kaplan-Meierove analize i log rang testa. Rezultati. Ekspresiju p63 imalo je 49,4% bolesnika. Pozitivnu ekspresiju (p63+) imalo je 38,8%, a slabu ekspresiju (p63+-) 10,6% bolesnika. Pozitivna ekspresija je ustanovljena kod 93,9% SCK, kod 5% adenokarcinoma (AC) i nijednog neklasifikovanog (NK) NSĆKP. Slaba ekspresija je nađena kod 12,5% AC, 25% NNS i kod 3% SCK. Analizom uticaja prisustva ekspresije p63 na inicijalni odgovor na hemioterapiju nije utvrdjena statistička značajnost. Bolesnici sa slabom ekspresijom p63 imali su značajno kraće vreme ukupnog preživljavanja u odnosu na bolesnike bez ekspresije p63 (p = 0.049) i tendenciju kraćeg vremena ukupnog preživljevanja u odnosu na bolesnike sa ekspresijom p63 (p = 0.068). Zaključak. Ovim istraživanjem ustanovljeno je da ekspresija p63 nema prediktivni značaj za odgovor na inicijalnu hemioterapiju po gemcitabin/cisplatin ili paklitaksel/cisplatin protokolu kod uznapredovalog NSĆKP. Slaba ekspresija p63 ima negativan prognostički značaj u III i IV stadijumu NSĆKP.

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