TUBB3的表达对晚期胃癌紫杉类药物化疗疗效和预后的影响  

Correlation of TUBB3 expression with chemotherapy sensitivity and clinical outcome of advanced gastric cancer treated with paclitaxel-based chemotherapy

作　　者：刘新福 尹婵 张辉 刘腾飞[2] 

机构地区：[1]邵阳市中心医院肿瘤科,湖南省邵阳市422000 [2]南方医科大学南方医院病理科

出　　处：《中国肿瘤临床》2017年第24期1248-1252,共5页Chinese Journal of Clinical Oncology

基　　金：湖南省医药卫生科研计划课题项目(编号:B2011-138)资助~~

摘　　要：目的:检测晚期胃癌组织中β-微管蛋白Ⅲ(classⅢβ-tubulin,TUBB3)的表达,分析TUBB3的表达与紫杉类药物化疗疗效及患者预后的相关性。方法:选取邵阳市中心医院2008年12月至2011年12月接受含多西他赛或紫杉醇为基础化疗的晚期胃癌患者49例,免疫组织化学检测胃癌组织中TUBB3蛋白的表达水平,分析TUBB3的表达与化疗疗效、无进展生存期(progressionfree survival,PFS)和总生存期(overall survival,OS)的关系。结果:49例患者接受含多西他赛或紫杉醇为基础的化疗,有3例患者因组织标本太少被剔除,化疗疗效达完全缓解(complete response,CR)1例、部分缓解(partial response,PR)17例、稳定(stable disease,SD)22例、进展(progression disease,PD)6例,化疗总有效率(CR+PR)为39.13%(18/46),TUBB3低表达组有效率为54.17%,TUBB3高表达组有效率为22.73%,两者比较差异具有统计学意义(χ2=4.736,P=0.029)。TUBB3低表达组患者的中位PFS和OS分别为5.9个月和11.6个月,TUBB3高表达组患者的中位PFS和OS分别为3.9个月和7.9个月,TUBB3低表达组较高表达组的PFS和OS均延长,差异有统计学意义(PFS:P=0.032;OS:P=0.001)。单因素及多因素分析得出,TUBB3均为晚期胃癌的独立预后因素。结论:晚期胃癌组织中TUBB3的表达与紫杉类药物化疗疗效及预后具有相关性,低表达组的化疗疗效及生存预后好于高表达组。可为临床上晚期胃癌个体化治疗的制定及判断预后提供参考。Objective： To investigate the expression of class III I^-tubulin （TUBB3） in advanced gastric cancer and analyze its correlation with the chemotherapeutic effect of paclitaxel and the prognosis of patients. Methods： This study reviewed 49 cases with advanced gastric cancer, diagnosed from December 2008 to December 2011 at Shaoyang Central Hospital. All patients were treated with paclitax- el or docetaxel-based chemotherapy. TUBB3 expression was determined using immunohistochemistry. Relationships of the expression of TUBB3 protein with chemotherapy response, progression-free survival （PFS）, and overall survival （OS） were analyzed. Results： Among the 46 valid cases treated with paclitaxel or docetaxel-based regimen, treatment response was as follows： complete response （CR） in 1 patient, partial response （PR） in 17 patients, stable disease （SD） in 22 patients, and progression disease （PD） in 6 patients. The overall response rate （CR＋PR） was 39.13% （18/46）. The chemotherapy response rates in low and high TUBB3 expression groups were 54.17% （13/24） and 22.73% （5/22）, respectively （X2=4.736, P=0.029）. The patients with low TUBB3 expression had significantly longer median PFS and OS than those with high TUBB3 expression （PFS 5.9 vs. 3.9 months, P=0.032; OS 11.6 vs. 7.9 months, P=0.001）. Univariate analysis and multivariate Cox regression analysis showed that the expression of TUBB3 was an independent prognostic factor in advanced gastric cancer. Conclusions： The present study demonstrates that TUBB3 expression in advanced gastric cancer is associated with chemotherapy response and prognosis; especifically, the low expression group had a better chemotherapy response and prognosis than the high expression group. The result of this study may provide a new sight for tailored chemotherapy and for predicting prog- nosis of individuals with advanced gastric cancer.

关 键 词：胃肿瘤 TUBB3 化学治疗 免疫组织化学 

分 类 号：R735.2[医药卫生—肿瘤]