The Effect Of Neoadjuvant Chemotherapy On Ultrastructures And The Expression Of Ki-67,Bcl-2 And CD44s In Patients With Non-small Cell Lung Cancer

Objective: To investigate the effect of neoadjuvant chemotherapy (NACT) on ultrastructures and the expression of Ki-67, Bcl-2 and CD44s in patients with NSCLC Methods :The expression of Ki-67, Bcl-2 and CD44s of 20 patients with NSCLC were examined respectively with immunohistochemical technique (PV-9000) before and after NACT;In addition,35 patients with stage Ⅰ—Ⅲ were treated with NACT followed by surgery (including the 20 cases above), and another 35 patients with the same stage and standard were treated with surgery only as control. Ultrastructural analyses were performed on 5 cases..treated before and after NACT.Results: Patients treated before and after NACT 1, After NACT, the positive rate of Ki-67 of 16 cases went down, showing significant difference (P<0.001). For patients of Stage Ⅰ-Ⅱ, the positive rate of 5 cases decreased, showing no significant difference(P>0.05),but for patients of stage Ⅲ, the positive rate of 11 cases decreased, showing significant difference (P<0.001).2, After NACT, 7 cases with positive bcl-2 turned to negative, no negative turned to positive, showing significant difference (P<0.05), for patients of stage I-II, there was no significant difference (P=1.000);while for patients of stage III, significant difference was found(P=0.030)..3, Significance was found between positive lymph node group and negative lymph node group before NACT(P=0.022).There were no significant difference on the expression of CD44s before and after NACT(P>0.05),for patients of stage Ⅰ-Ⅱ and stage Ⅲ, no significant differences was found. 4, After NACT, ultrastructures of tumor cells showed various degrees of injured changes, for example, organelles swollen , breaking up or forming vacuoles, chromatin congregating to the margin like masses, besides, apoptosis phenomenon was found, in some cells. NACT group and control group 1, Ki-67 LI in NACT group was lower compared with control group (P<0.001) . For patients of stage Ⅰ-Ⅱ , no significant difference was found (P>0.05) ,while for patients of stage Ⅲ, significant difference was found (P<0.001);For positive lymph node groups, significant difference was found (P<0.001), and for negative lymph node groups ,no significant difference was found (P>0.05) .2, Positive expression rate of Bcl-2 in NACT group was significantly lower compared with control group ( P<0.01 );For patients of stage Ⅰ-Ⅱ ,no significant difference was found (P=0.289) ,while for patients of stage Ⅲ, significant difference was found(P=0.002);For positive lymph node groups, significant difference was found (P<0.01), no significantdifference is found for negative lymph node groups(P=0.109). 3-. As to CD44s, there were no significant difference between groups except that positive lymph node group and negative lymph node group of control(P=0.032).Conclusions: 1> Neoadjuvant chemotherapy can inhibit proliferation of tumor cells and can induce tumor cells apoptosis of NSCLC with stage III and with metastasis of lymph node.2N Whether neoadjuvant chemotherapy can inhibit proliferation of tumor cells and can induce tumor cells apoptosis or not of NSCLC with none-metastasis lymph node of stage I-II was not found, and feasibility of treating with neoadjuvant chemotherapy on these cases needs further study. 3> Strong expression of CD44s in positive lymph node group was lower compared with negative lymph node group, however,the influence of NACT on the expression of CD44s was not found. 4> After NACT, ultrastructures of tumor cells were damaged to different levels. 5^ The mechanism of NACT on NSCLC is perhaps inducing tumor cells apoptosis and inhibiting tumor cells proliferation .according to our foundings.Postgraduate: Yu Xun zong (Pathology) Directed by: Prof. Xiang Feng gang...