肾透明细胞癌MAPK9的表达与索拉非尼疗效的关系  

Relationship between MAPK9 Expression in Renal Clear Cell Carcinoma and the Efficacy of Sorafenib Targeted Therapy

作　　者：杨平[1,2] 薛沁[1] 闫飞[1] 师菲[1] 郑万祥 王福利[1] 秦卫军[1] 武国军[1] 田春娟[1] 袁建林[1] 

机构地区：[1]第四军医大学西京医院泌尿外科,陕西西安710032 [2]安康市中医院泌尿外科,陕西安康725000

出　　处：《现代生物医学进展》2015年第22期4298-4302,共5页Progress in Modern Biomedicine

基　　金：陕西省科技统筹(2012KTCL03-03)

摘　　要：目的：探讨肾透明细胞癌组织中MAPK9表达及其与肾透明细胞癌主要临床病理特征之间的关系,分析MAPK9对索拉非尼靶向治疗疗效的关系。方法：回顾分析2006年5月-2013年10月经病理确诊的32例肾透明细胞癌转移患者的MAPK9的表达情况。所有患者术后均服用索拉菲尼并随访;同时选取10例距肿瘤3 cm癌旁正常肾组织作为对照。对比分析肾透明细胞癌患者与对照组MAPK9的阳性表达率,分析MAPK9阳性表达与疗效的相关性,并分析MAPK9阳性表达与生存率之间的关系。结果：肾透明细胞癌组MAPK9阳性表达21例（65.6%）,较正常对照组2例（20.0%）有显著性差异（P〈0.01）。TNMⅠ~Ⅱ期MAPK9阳性表达12例（85.7%）,较TNMⅢ~Ⅳ期10例（55.6%）有显著性差异（P〈0.05）;核分级1~2级MAPK9阳性表达18例（81.8%）,较3~4级4例（40.0%）有显著性差异（P〈0.05）。MAPK9阳性表达患者与阴性表达患者疗效有显著性差异（P〈0.05）。MAPK9阳性患者PFS为（646±103）d,较阴性患者PFS为（502±89）d,有显著性差异（P〈0.05）。MAPK9阳性患者OS为（866±75）d,较阴性患者OS为（657±62）d,有显著性差异（P〈0.01）。结论：MAPK9在肾透明细胞癌中高表达,与肿瘤的临床TNM分期、病理分级相关。MAPK9阳性表达患者其靶向治疗疗效越好,提示MAPK9可能是一个预测索拉菲尼靶向治疗肾透明细胞癌疗效的潜在因子。Objective： To investigate the expression of MAPK9 in renal clear cell carcinoma and analyze the influence of MAPK9 on sorafenib targeted therapy efficacy. Methods： 32 patients were enrolled and treated with sorafenib after nephrectomy. The expression of MAPK9 was tested immunohistochemically in the 32 specimens of primary renal tumors. The survival difference between MAPK9-positive and MAPK9-negative patients was compared, and the correlation between MAPK9 status and curative effect was compared. Results： MAPK9 was positive expression in 21 cases of renal clear cell carcinoma （65.6 %）, with significant difference compared with control group in which MAPK was positive in 2 cases （20 %） （P 〈 0.01）.There was 12 cases of MAPK 9 positive expression ofTNM I - II phase （85.7 %）, higher than that ofTNM III- IV in 10 cases （55.6 %） with significant difference （P 〈 0.05）; there was 18 MAPK9-positive cases in nuclear grade 1 to grade 2 （81.8%）, higher than 4 cases （40 %） in3 - 4 grade （P 〈 0.05）. Progression free survival （PFS）was （646± 103） d for MAPK9 positive patients and （502± 89） d for MAPK9 negative patients, and the difference was statistically significant（P 〈 0.01）. Overall survival （OS）time was （866± 75） d for MAPK9 positive patients and （657± 62） d for MAPK9 negative patients, and the difference between them was statistically significant （P〈0.01）. Conclusions： MAPK9 can be a potential predictive factor for renal clear cell carcinoma treated with sorafenib, and patients with positive MAPK9 expression might have better prognosis and obtain longer overall survival time.

关 键 词：肾透明细胞癌 索拉菲尼 促分裂原活化蛋白激酶9 疗效 

分 类 号：R737.11[医药卫生—肿瘤]