Abstract:

Objective To investigate the relationship between serum cytokeratin 18 (CK18) levels and resistance to paclitaxel chemotherapy in patients with non-small cell lung cancer. Methods Thirty patients with non-small cell lung cancer in stable or better state of illness evaluated with RECIST at the end of first cycle of chemotherapy with paclitaxel and carboplatin (2 to 6 cycles) were enrolled, and peripheral blood samples were taken at the end of first cycle of chemotherapy and at the onset of disease progression (drug resistance). Serum CK18 levels were detected by ELISA before and after drug resistance. Results The serum CK18 levels before and after drug resistance were (0.356±0.199) ng/mL and (0.566±0.189) ng/mL, respectively, and there were significant differences between them (P=0.002). Serum CK18 levels slightly decreased (by less than 20%) in 4 patients, all of whom were evaluated as disease progression (drug resistance) at the end of second cycle of chemotherapy. For the other 26 patients with increased serum CK18 levels, all experienced disease progression after at least 3 cycles of chemotherapy, with 20 patients increased by more than 20% (maximum, 947.17%). Conclusion Serum CK18 levels are associated with resistance to paclitaxel chemotherapy in patients with nonsmall cell lung cancer, and detection of CK18 levels may provide references for individual treatment of patients with advanced non-small cell lung cancer.

Key words: non-small cell lung cancer, paclitaxel, chemotherapy, cytokeratin 18