凋亡刺激蛋白抑制因子表达对鼻咽癌预后预测的研究  

Prognostic value of iASPP for nasopharyngeal carcinoma

作　　者：吴芳[1] 方业颖[1] 胡凯[1] 张勇[1] 王仁生[1] 

机构地区：[1]广西医科大学第一附属医院放疗科,南宁530021

出　　处：《中华放射医学与防护杂志》2017年第4期273-277,共5页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的 探讨凋亡刺激蛋白抑制因子（iASPP）的表达水平与鼻咽癌预后的关系.方法 随访2012年1月至12月广西医科大学第一附属医院放疗科治疗的初诊鼻咽癌患者130例.临床分期依据2009 AJCC/UICC分期标准.所有患者均接受调强放射治疗,Ⅲ～ⅣB期患者行铂类为基础的同步放化疗.采用免疫组织化学法检测iASPP在130例鼻咽癌组织中的表达情况,比较iASPP表达与临床病理因素的关系,并分析其表达对鼻咽癌患者疗效和生存的影响.结果 130例患者中iASPP阳性表达者86例（66.2％）,阴性表达者44例（33.8％）.不同N分期和临床分期患者的iASPP阳性表达率比较,差异有统计学意义（x2=7.565、4.947,P＜0.05）.治疗后3个月,iASPP阳性表达者与阴性表达者的近期疗效差异无统计学意义（P＞0.05）.单因素分析显示,iASPP阳性表达者3年无远处转移生存（DMFS）和无进展生存（PFS）均低于iASPP阴性表达者（82.6％ vs.95.4％,x2=4.335,P=0.037和74.4％ vs.93.1％,x2=6.640,P=0.01）.N2～3患者3年DMFS、PFS和总生存（OS）均低于N0～1患者（x2=8.058、9.554、6.987,P＜0.01）.多因素分析显示,iASPP表达水平及N分期是影响PFS的独立预后因素（x2=4.336、5.228,P＜0.05）.结论 鼻咽癌患者iASPP阳性表达水平升高是影响预后的不利因素. Objective To evaluate the prognostic value of iASPP for nasopharyngeal carcinoma （NPC）.Methods One hundred and thirty patients with nasopharyngeal carcinoma were initially diagnosed and treated between January and December 2012 in Department of Radiation Oncology of the First Affiliated Hospital of Guangxi Medical University.The clinical staging was classified according to the cancer staging criteria 2009 AJCC/UICC.All patients were treated by IMRT.Cisplatin-based concurrent chemotherapy was given to patients with stages Ⅲ-ⅣB disease.Immunohistochemistry was used to detect the expression of iASPP in the carcinoma tissues,and the clinicopathological features were compared among the patients with different expressions of iASPP.Furthermore,the relationship between the expression of iASPP and the efficacy in patients was explored.Results Of 130 patients,positive expression of iASPP was observed in 86 patients （66.2%）,and negative expression in 44 patients （33.8%）.There was significant difference in the positive expression rate of iASPP among the patients with different N-stage and clinical stages（x2 =7.565,4.947,P 〈 0.01）.At three months after treatment,no significant difference was found in the response rate of tumor with different expression of iASPP.In univariate analysis,the expression of iASPP was significant predictor of 3 year-DMFS （x2 =4.335,P =0.037） and PFS （x2 =6.640,P =0.01）.Furthermore,N-stage was significant predictor of 3y-DMFS （x2 =8.058,P =0.005）,PFS （x2 =9.554,P =0.002） and OS （x2 =6.987,P =0.008）,respectively.By using multivariate Cox analysis,the expression of iASPP and N-stage was independent prognostic factors for PFS （x2 =4.336,5.228,P 〈 0.05）,respectively.Conclusions Positive expression of iASPP may be a poor prognostic factor for NPC patients.

关 键 词：凋亡刺激蛋白抑制因子 鼻咽肿瘤 预后 

分 类 号：R739.63[医药卫生—肿瘤]