APAF-1和COX-2表达程度与局部晚期直肠癌neo—CRT后pCR相关性研究  

Relationship of expression of APAF-1 and COX-2 with pathologic complete response to neoadjuvant chemoradiotherapy for locally advanced rectal adenocarcinoma

作　　者：彭海花[1] 余昕[2] 奚少彦[3] 张天[1] 董隽[1] 游凯云[2] 蔡木炎[3] 王成涛[1] 张惠忠[3] 文碧秀[1] 高远红[4] 

机构地区：[1]中山大学附属第一医院放疗科,广州510080 [2]华南肿瘤学国家重点实验室 中山大学肿瘤防治中心放疗科,广州510060 [3]华南肿瘤学国家重点实验室 中山大学肿瘤防治中心病理科,广州510060 [4]广州医科大学附属肿瘤医院放疗科,广州510075

出　　处：《中华放射肿瘤学杂志》2016年第5期462-466,共5页Chinese Journal of Radiation Oncology

基　　金：国家自然科学基金（81172209,81071891）;广东省科技计划项目（2010B0807017,2010B031600090）;广东省自然科学基金（S2011020003612）

摘　　要：目的探讨局部晚期直肠癌组织中APAF-1、COX．2表达程度与新辅助同期neo．CRT后pCR相关性。方法收集2005--2012年行neo—CRT及根治性手术的82例局部晚期直肠癌疗前癌组织石蜡包埋切片，采用免疫组化法评估APAF．1、COX-2表达水平。复阅术后病理组织切片，评估放化疗后肿瘤退缩等级（0—4级，pCR为4级）。分析APAF-1、COX-2表达程度与pCR是否相关。χ^2检验或Fisher’s精确概率法检验。结果neo—CRT后0、1、2、3、4级分别为0、6（7％）、33（40％）、20（24％）、23（28％）例。APAF-1高表达组pCR率高于低表达组（37％：17％，P=0．047），COX-2低表达组pCR率高于高表达组（38％：15％，P=0．028）。APAF．1高表达／COX-2低表达组pCR率高于APAF－1高表达／COX－2高表达组、APAF—1低表达／COX-2低表达组、APAF—1低表达／COX-2高表达组（56％、14％、17％、15％，P=0．005）。APAF-1表达程度与pCR呈正相关（P=0．042），COX-2表达程度与pCR呈负相关（P=0．024）。结论APAF-1、COX-2表达程度与局部晚期直肠癌经neo—CRT后是否达pCR存在相关性，两者联合检测对pCR有更高预示价值。Objective To investigate the relationship of expression of apoptosis protease-activating factor 1 （APAF-1） and cyclooxygenase-2（COX-2） with pathologic complete response （pCR） to neoadjuvant chemoradiotherapy （neo-CRT） for locally advanced rectal adenoearcinoma. Methods Paraffin-embedded tumor tissue sections were collected from 82 patients with locally advanced rectal adenoearcinoma who received neo-CRT and radical surgery from 2005 to 2012. Immunohistochemical assay was used to determine the expression of APAF-1 and COX-2. Postoperative pathological tissue sections were reassessed for evaluation of tumor regression grade （0-4, pC R = 4） after radiochemotherapy. The relationship of expression of APAF-1 and COX-2 with pCR was analyzed by ehi-square test or Fisher＇s exact test. Logistic regression analysis was used to predict the influencing factors for pCR. Results The numbers of patients with grade O, 1, 2, 3, and 4 tumor regression were 0, 6 （ 7% ）, 33 （ 40% ）, 20 （ 24% ）, and 23 （ 28% ）, respectively. Patients with high expression of APAF-1 had a significantly higher incidence of pCR than those with low expression of APAF-1 （ 37% vs. 17%, P= 0. 0d-7 ） , while patients with low expression of COX-2 had a significantly higher incidence of pCR than those with high expression of COX-2（38% vs. 15%, P=0. 028）. Patients with high expression of APAF-1 and low expression of COX-2 had a significantly higher incidence of pCR than patients with high expression of APAF-1 and COX-2, patients with low expression of APAF-1 and COX-2, and patients with low expression of APAF-1 and high expression of COX-2（56% vs. 14% ;56% vs. 17%;56% vs. 15%; P= 0. 005）. The expression of APAF-1 was positively correlated with pCR （P= 0. 042 ） , while the expression of COX - 2 was negatively correlated with pCR （ P= 0. 024 ） . Conclusions The expression of APAF-1 and COX-2 is correlated with pCR to neo-CRT for locally advanced rectal adenocarcinoma. The measurement of expression of both AP

关 键 词：凋亡蛋白活化因子-1 环氧合酶-2 直肠肿瘤 新辅助放化疗 病理完全缓解 

分 类 号：R735.37[医药卫生—肿瘤]