| Objective:To explore the relationship between short-term effect of chemotherapy in the initial diagnosis of lung adenocarcinoma and immunohistochemical expression of Ki-67 molecule level, and to find the value of the Ki-67 expression in neoadjuvant chemotherapy and the chemotherapy in patients with lung adenocarcinoma.Methods:This study use the retrospectively analyzed methods, all patients were collected Shandong Provincial Hospital Respiratory ward from February 2014 to December 2015 hospitalized and confirmed by pathological examination of lung adenocarcinoma with immunohistochemical factors Ki-67 index for the study. All patients with lung adenocarcinoma were given pemetrexed combined platinum agents in the treatment. All patients would be assessed after two cycles of chemotherapy. According to the diagnosis of pathological tissue immunohistochemistry molecule ki-67 expression levels they were divided into two groups:(1) I group (ki-67<10%, low expression group); (2) II group (ki-67> 10%, high expression group). We analyze the early-term chemotherapy efficiency and the expression level of Ki-67 factor. In accordance with condition of the patient history the study also explore the Ki-67 expression difference in the subgroups. Based on solid tumor curative effect evaluation standard from RECIST, the Ki-67 expression would be analyzed in efficiency of chemotherapy and other trait in subgroup to explore the relationship.Results:The study based on inclusion and exclusion criteria were collected 58 cases of lung adenocarcinoma patients in the group, aged 40-75 years,29 males and 29 females. Early Chemotherapy Clinical Analysis:There were no complete remission (CR) patients in two group. In group I,0 cases with partial remission (PR) in patients,26 patients with stable disease(SD),4patients with progress disease (PD), the response rate (RR=CR+PR) was 0% (0/30), the disease control rate (DCR) was 86.7%(26/30); In group II,4 cases with PR, 21eases with SD,3 cases with PD, the RR was 14.3%(4/28), the DCR was 89.3%(25/28). RR comparison in two groups was significantly different, the RR in group II (high expression group) was significantly higher than that in group I, P<0.05. DCR in two groups had no significant difference (P> 0.05). Ki-67 expression level was no significant difference in the other factors in other subgroups.Conclusions:1, In patients with lung adenocarcinoma Ki-67 positive expression, the chemotherapy pemetrexed combined with platinum agents might be low and in this group of patients into the overall response rate was only 6.9%, but it need more research to be further confirmed.2, For the assessment of lung adenocarcinoma in the early chemotherapy in two groups, the RR in the group which was the Ki-67 high expression there are more better than the low expression of Ki-67 group, P<0.05. But the disease control rate was also no significant difference. Therefore considered Ki-67 expression levels can be used as predictors of chemotherapy drugs’ sensitivity indicators and neoadjuvant chemotherapy for lung cancer clinical efficacy. If it can be determined the level of expression in the case of critical values, this can be applied to predict the effect of radiotherapy or chemotherapy in small-cell lung cancer and squamous cell cancer. It also need more research to be further confirmed.3, Ki-67 expression level and the level of sex, age, PS score and whether smoking and other factors had no significant statistical difference associated with the majority of previous research conclusions same.4, The patients which is in T2 stage is most in this study, it’s percentage of 67.2%, but did not find the level of Ki-67 expression levels were significantly correlated in TNM staging. Combined with other research we considered the Ki-67 expression level in staging pTNM might be more accurate verification. |
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