网络首发:2012-11-20,
纸质出版:2012
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双链RNA依赖的蛋白激酶在非小细胞肺癌预后预测及靶向治疗中的作用[J]. 中山大学学报(医学科学版), 2012,33(6).
Value of Double-stranded RNA-dependentProtein Kinase on Prognosis Prediction and Screening Target Therapy for Non-Small Cell Lung Cancer[J]. Journal of Sun Yat-sen University (Medical Sciences), 2012, 33(6).
【目的】 探索双链RNA依赖的蛋白激酶(PKR)联合其他肿瘤代谢相关蛋白能否作为非小细胞肺癌(NSCLC)的更有效的预测因子;同时拟研究部分肿瘤代谢相关化合物,如胰岛素样生长因子1受体(IGF-1R)抑制剂、哺乳动物雷帕霉素靶蛋白(mTOR)抑制剂等与PKR表达的关系,拟求达到更好的靶向治疗及个体化治疗的目的。【方法】 免疫组化检测212例NSCLC中PKR、IGF-1R表达情况,并用于Kaplan-Meier生存分析。Western Blotting检测13种肺癌细胞株PKR、p-PKR表达;磺基罗丹明B法(SRB)检测PPP、Rapamycin等药物作用后对高表达及低表达p-PKR细胞的抑制率。【结果】 全组NSCLC患者中,PKRlow/IGF-1Rhigh 患者的5年总生存率(21.6%) 明显低于PKRhigh/IGF-1Rlow 患者 (74.6%) 及其他患者 (58.2%) (P < 0.0001),单、多因素分析提示PKR/IGF-1R联合标记物为NSCLC患者总生存率的独立预后因素。SRB结果提示,第1 ~ 3天,IGF-1R抑制剂PPP 3 μmol/L在6个肺癌细胞株中均能显著抑制细胞生长,在0.3 μmol/L剂量低表达PKR和/或p-PKR 的H1792和H292细胞株中,较其他细胞株更能抑制细胞生长。而mTOR抑制剂Rapamycin采用1、0.1及0.01 μmol/L 3个剂量级在各细胞株均未见明显抑制细胞生长的区别。【结论】 PKR联合IGF-1R可预测NSCLC的预后,PKR低表达的H1792、H292细胞株中,IGF-1R抑制剂PPP具有显著抑制作用,但对于mTOR抑制剂Rapamycin,未见明显作用,提示可通过检测PKR的表达来选择适合IGF-1R抑制剂PPP的病人。
【Objective】 Double-stranded RNA-dependent protein kinase (PKR) is a hot pot in cancer research. However, it should be confirmed that whether PKR is an independent prognostic variable in the patients with non-small cell lung cancer (NSCLC). In the present study, we investigated the correlation between PKR and metabolism related biomarkers for NSCLC, identified the markers that could further improve the prognostic significance of PKR. On the other hand, we planned to study the relationship between PKR and some tumor metabolism related products, such as IGF-1R inhibitors and mTOR inhibitors, so as to improve the outcome of individualized target treatment. 【Methods】 Tissue samples obtained from 212 lung cancer patients were stained with an anti-PKR and anti-IGF-1R. Immunohistochemical expression was scored and used for Kaplan-Meier survival analysis. Western blotting was used to analysis PKR and p-PKR expression in 13 lung cancer cell lines, and Sulforhodamine B method (SRB) was used to detect drug inducing Cell inhibitory rate. 【Results】 The 5-year overall survival rate in PKRlow/IGF-1Rhigh patients (21.6%) was significantly lower than that of PKRhigh/IGF-1Rlow patients (74.6%) and others patients (58.2%) (P < 0.0001). Univariate and multivariate Cox analyses revealed that this PKR/IGF-1R combination was an independent predictor of overall survival. SRB suggested that IGF-1R inhibitor PPP can significantly inhibit cell growth in all of the six cell lines in 3 μmol/L dose in d1-3. In 0.3 μmol/L doses, PPP can inhibit the cell growth in H1792 and H292 cells,which weakly expressed PKR and/or p-PKR. There were no significant difference when treated in mTOR inhibitor Rapamyc in 3 dose levels(1,0.1 and 0.01 μmol/L) in 6 cell lines. 【Conclusion】PKR/IGF1-R is a significant predictor of prognosis for NSCLC. PKR/IGF1-R may be a promising approach to improving screening efficiency and predicting prognosis in NSCLC patients. H292, H1792, which are low expression of PKR, are sensitive to IGF-1R inhibitor PPP , but not to mTOR inhibitor Rapamycin. What’s more, it’s valuable to select the NSCLC patients who are sensitive to the IGF-1R inhibitor with the detection of PKR expression.
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