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作 者:孙建华[1] 陶秀娟[2] 陈立群[1] 马兴媚[1] 温凤云[1] 王纯雁[1]
机构地区:[1]北京大学首钢医院,北京100041 [2]辽宁省肿瘤医院,辽宁沈阳110042
出 处:《大连医科大学学报》2008年第4期321-324,328,共5页Journal of Dalian Medical University
摘 要:[目的]研究DNA-PKcs、P53的表达与宫颈癌放疗敏感性及预后的关系。[方法]Ⅰb-Ⅱb期宫颈癌患者63例,术前放疗DT1400 cGy/2次,14 d后行根治术,据术后病理放疗反应分为放疗敏感与放射抗拒两组;免疫组化S-P法检测DNA-PKcs、P53蛋白在治疗前宫颈癌组织中的表达;分析两组表达差异有无显著性意义,二因子有无相关性,及其与生存期的关系。[结果]DNA-PKcs在正常宫颈鳞状上皮、腺上皮中不表达,在癌细胞核中的阳性表达率10%~100%,中位数70%,均数66.67%(标准误2.94%)。DNA-PKcs在放疗敏感组32例中有7例高表达,放射抗拒组31例中有30例高表达(χ^2=36.444,P〈0.001);DNA-P Kcs高表达组总生存时间均数51月,低表达组59月。P53在癌细 胞核中的表达率0~35%,中位数0,均 数8.49%(标准误1.57%)。P53在放疗敏感组32例中有6 例高表达,放射抗拒组31例中有16例高表达(χ^2=7.483,P〈0.001);DNA-PKcs与P53相关系数r= 0.276(P〈0.05双侧)。[结论]DNA-PKcs、P53可作为早期宫颈癌放疗敏感性的预测指标,高表达者易放射抗拒;DNA-PKcs与P53表达正相关;DNA-PKcs低表达者预后较好。[Objective] To investigate theassociation of tumor response to radiotherapy and survival with theexpression of DNA-PKcs and P53.[Methods] Sixty-three patients,pathologically diagnosed cervical cancer,FIGO-stageⅠb-Ⅱb,treated with preoperative brachytherapy,DT1400cGy/2f/14 d,followed by radical surgery,were divided into two groups according to pathological tumor response to radiation-radioresistant or radiosensitive.Formalin-fixed primary uterine cervicaltumor biopsies were investigatedby immunohistochemistry.Expression of P53 and DNA-PKcs in primary tumors was compared and analyzed between the two groups.Correlation between P53 and DNA-PKcs was studied.Survival analysis was also performed.[Results] Tumor-transformed tissue showed positive immunostaining of DNA-PKcs while non-neoplastic squamous epithelium and tumor-free cervix glands showed negative immunoreactivity.The percentage of nuclear-staining-positive cells varied between 10% and 100%,with a median of 70%,(mean:66.67%+/-2.94%).It was found that 7 of 32 cases to be DNA-PKcs-high-express in the radiosensitive group,while 30 of 31 in the radioresistant one.DNA-PKcs-high-express tumors showed significantly much radioresistant than DNA-PKcs-low-expressones(χ^2=36.444,P〈0.001) and the latter has a significantly better overall survival(59 months vs 51 months).The percentage of P53-positive cells varied between 0 and 35%,with a median of 0(mean:8.49%+/-1.57%).P53-high-expresswas found in 6 of 32 cases in the radiosensitive group,while 16 of 31 in the radioresistant one.Positive P53 tumors were significantly more common in the radioresistant group(χ^2=7.483,P〈0.001).Moreover,significantly positive correlation between P53 and DNA-PKcs was also found.(r=0.276,P〈0.05,bilateral).[Conclusion]DNA-PKcs and P53 couldbe used as predictive markers for radiotherapy response in cervical cancer,high expression of DNA-PKcs and P53 leads to radioresistance;And the two facters have positive correlation;In addition,overall survival issign
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