FOLFOX4新辅助化疗对直肠癌组织Ki-67、MMP-2和Fas表达的影响  

Effect of Neoadjuvant Chemotherapy With FOLFOX4 on Expressions of Ki-67,MMP-2 and Fas in Rectal Cancer

作　　者：毕利萍[1] 李玉军[1] 郭茜[1] 于晓彬[1] 宋臻[1] 乔宏杰[1] 张洪岩[1] 齐秀恒[1] 

机构地区：[1]中国石油天然气集团公司中心医院肿瘤科,065000

出　　处：《胃肠病学》2017年第11期658-661,共4页Chinese Journal of Gastroenterology

摘　　要：背景:直肠癌为消化道常见恶性肿瘤。以奥沙利铂为基础的新辅助化疗对直肠癌患者疗效确切,但其作用机制尚未完全明确。目的:探讨FOLFOX4(亚叶酸钙+氟尿嘧啶+奥沙利铂)新辅助化疗对直肠癌患者肿瘤组织中增殖细胞相关核抗原Ki-67、基质金属蛋白酶-2(MMP-2)和死亡受体Fas蛋白表达的影响。方法:前瞻性纳入2014年8月—2016年2月中国石油天然气集团公司中心医院病理确诊直肠癌患者104例,随机分为治疗组(n=58)和对照组(n=46),治疗组患者术前接受6个疗程FOLFOX4方案新辅助化疗,对照组患者直接行手术治疗。取术后肿瘤组织标本,以免疫组化法检测Ki-67、MMP-2、Fas蛋白表达。结果:直肠癌组织中Ki-67主要表达于细胞核,MMP-2、Fas主要表达于细胞质。治疗组Ki-67、MMP-2阳性表达率显著低于对照组(41.4%对80.4%,P<0.05;36.2%对73.9%,P<0.05),Fas阳性表达率显著高于对照组(62.1%对32.6%,P<0.05)。结论:FOLFOX4新辅助化疗对直肠癌治疗作用的机制可能与抑制肿瘤细胞的增殖、侵袭和转移能力以及促进肿瘤细胞凋亡有关。Background： Rectal cancer is a common malignant tumor of alimentary tract. It has been demonstrated that oxaliplatin-based neoadjuvant chemotherapy is effective for rectal cancer, however, its mechanism is not fully clarified. Aims： To explore the effect of neoadjuvant chemotherapy with FOLFOX4 （folinic acid, fluorouracil, and oxaliplatin） on expressions of Ki-67, a proliferating cell-associated nuclear antigen, matrix metalloproteinase-2 （MMP-2）, and Fas, a death receptor in cancerous tissue of patients with rectal cancer. Methods： A total of 104 cases of patients with histologically proven rectal cancer from Aug. 2014 to Feb. 2016 at Central Hospital of China National Petroleum Corporation were enrolled prospectively and randomly allocated into treatment group （n=58） and control group （n=46）. Patients in treatment group finished 6 cycles of neoadjuvant chemotherapy with FOLFOX4 before surgery, and those in control group underwent surgery directly. Expressions of Ki-67, MMP-2 and Fas protein in cancerous tissue of surgical specimens were determined immunohistochemically. Results： Immunoreactivity of Ki-67 mainly located in the nucleus of rectal cancer cells, and those of MMP-2 and Fas mainly located in the cytoplasm. Expression rates of Ki-67 and MMP-2 were significantly lower in treatment group than in control group （41.4% vs. 80.4%, P〈0.05; 36.2% vs. 73.9%, P〈0.05）, while those of Fas was significantly higher in treatment group than in control group （62.1% vs. 32.6%, P〈0.05）. Conclusions： The therapeutic effect of neoadjuvant chemotherapy with FOLFOX4 on rectal cancer might be associated with the inhibition of proliferative, invasive and metastatic capacities and induction of apoptosis in cancer cells.

关 键 词：新辅助化疗 直肠肿瘤 KI-67抗原 基质金属蛋白酶2 受体 fas 免疫组织化 

分 类 号：R735.37[医药卫生—肿瘤]