32例晚期及术后复发肺肉瘤样癌患者的治疗及生存分析

Outcomes of Treatment of 32 Cases of Advanced or Relapsed Post-surgery Pulmonary Sarcomatoid Carcinoma

中文关键词:  肺肉瘤样癌 晚期 复发 治疗 生存分析

英文关键词:Pulmonary sarcomatoid carcinomas Advanced Stage Recurrence Treatment Survival analysis

中文摘要:

      目的 探讨Ⅳ期及术后复发肺癌肉瘤患者经三代化疗药物治疗的疗效及影响预后的因素。方法 回顾性分析经病理学确诊的32例肺肉瘤样癌患者临床资料，并对其治疗方案及可能影响预后的因素（性别、年龄、肿瘤部位、大小、术后复发或Ⅳ期、病理类型、吸烟状况）进行统计学分析。结果 32例肺肉瘤样癌患者中初诊Ⅳ期10例，复发或转移肺肉瘤样癌患者22例。所有患者均先后接受吉西他滨联合顺铂(GP)或紫杉醇联合顺铂(TP)方案化疗。中位总生存时间（OS）为14个月、中位无进展生存时间（PFS）为5个月，客观缓解率21.9%（7／32）。不同性别、年龄、部位、病理类型、接受TP或GP方案化疗及吸烟史的患者， OS差异均无统计学意义。肿瘤直径在>6 cm与≤6 cm患者，中位OS分别为16个月、12个月，两组间差异有统计学意义（P <0.05）。术后复发与Ⅳ期在患者中位OS分别为14个月、8个月，两组间差异有统计学意义（P<0.05）。初次诊断为Ⅳ期和肿瘤直径>6 cm是独立的不良预后因素。结论 在我们的研究中，TP和GP方案化疗对术后复发及Ⅳ期肺肉瘤样癌患者的疗效与其他研究中同期别的非小细胞肺癌近似，初次诊断为Ⅳ期和肿瘤直径>6 cm是独立不良预后因素。

英文摘要:

      【Abstract】 Objective To construct human protein kinase B (ATK2)， phosphoinositide-dependent kinase 1 (PDK1) and bcl-2-associated death protein (BAD) lentiviral expression vector, and to determine their expressions in 293T cells. Methods Total RNA was extracted from lung cancer tissues. The full-length coding regions of human ATK2, BAD and PDK1 cDNA were amplified via RT-PCR using specific primers, subcloned into PGEM-Teasy and then sequenced for confirmation. The full-length coding sequence was cut out with a specific restriction enzyme digest and subclone into pCDF1-MCS2-EF1-copATK2GFP. The plasmids were transfected into 293T cells using the calcium phosphate method. The over expression of AKT2, BAD and PDK1 were detected by Western blot. Results AKT2, PDK1 and BAD were subcloned into pCDF1-MCS2-EF1-copGFP, with an efficiency of transfection of 100%, 95%, and 90% respectively. The virus titers were 6.7×10⁶ PFU/mL in the supernatant. After infection, the proteins of AKT2, PDK1 and BAD were detected by Western blot. Conclusion The lentivial vector pCDF1-MCS2-EF1-copGFP containing AKT2, BAD and PDK1 were successfully constructed and expressed in 293T cells.