PDCD4表达水平与汉防己甲素联合放疗治疗Ⅱ-Ⅲ期食管癌疗效的相关性  

Correlation between the expression of PDCD4 and the therapeutic effect of tetrandrine combined with radiotherapy on stage Ⅱ-Ⅲ esophageal cancer

作　　者：王同甫 张振[1] 姚传山[1] 李芳芳[1] 王旭 Wang Tongfu;Zhang Zhen;Yao Chuanshan;Li Fangfang;Wang Xu(Nanyang First People's Hospital,Henan Nanyang 473012,China;Nanshi Hospital Affiliated of Henan University,Henan Nanyang 473065,China)

机构地区：[1]南阳市第一人民医院,河南南阳473012 [2]河南大学附属南石医院,河南南阳473065

出　　处：《现代肿瘤医学》2020年第9期1472-1475,共4页Journal of Modern Oncology

摘　　要：目的:观察汉防己甲素在食管癌放疗增敏过程中细胞程序性死亡基因4(PDCD4)表达情况,对比不同表达水平患者的不良反应、生存期的差异;同时分析其表达情况与生存期之间的相关性。方法:收集62例经病理诊断明确、PTNM分期在Ⅱ-Ⅲ期的食管癌患者,所有入组患者均进行汉防己甲素联合放疗,免疫组化方法检测治疗前患者癌组织中PDCD4表达情况,根据中位表达值将患者分为高表达组和低表达组,对比两组生存期的差异。结果:PDCD4在不同肿瘤浸润深度、淋巴结转移情况、分化程度及临床分期方面的表达存在显著差异(P=0.010;P=0.003;P=0.004;P=0.005);PDCD4高表达组放疗过程中发生骨髓抑制较低表达组减少(P=0.000),差异具有统计学意义;分别对比骨髓抑制的严重程度,发现在Ⅰ-Ⅱ级、Ⅲ-Ⅳ级分层对比中差异明显(P=0.005;P=0.001),差异具有统计学意义;PDCD4高表达组放疗过程中发生放射性食管炎较低表达组减少(P=0.011),差异具有统计学意义;根据严重程度分组对比后发现在Ⅰ-Ⅱ级放射性食管炎发生方面差异明显(P=0.022),差异具有统计学意义;Ⅲ-Ⅳ级无明显差异(P=0.392);高表达组患者中位结论:汉防己甲素放疗增敏过程中PDCD4的表达起到一定的作用,其高表达时患者放疗不良反应轻、PFS更长;PDCD4的表达与患者的预后存在一定的相关性。Objective:To observe the expression of PDCD4(programming cell death gene 4)during the sensitization of tubular cancer radiotherapy,compare the adverse reactions and survival time according to different expressions,and analyze the relationship between expression and survival time.Methods:A total of 62 esophageal patients with pathological diagnosis and PTNM stage II-III were enrolled.All patients were treated with tetrandrine combined with radiotherapy.Immunohistochemical method was used to detect the expression of PDCD4 in cancer tissues before treatment.The position expression values were divided into high expression group and low expression group,and the difference in survival between the two groups was compared.Results:In the comparative analysis of the two groups,the myelosuppression was decreased in the PDCD4 high expression group(P=0.000),and the difference was statistically significant.The severity of myelosuppression was compared and found in I-II.The difference between grade and III-IV stratification was significant(P=0.005,P=0.001),which was statistically significant.The radioactive esophagitis was decreased during radiotherapy in PDCD4 high expression group(P=0.011).The difference was statistically significant.According to the severity grouping,the difference was found to be significant in the occurrence of grade I-II radiation esophagitis(P=0.022),which was statistically significant.There was no III-IV significant difference(P=0.392).The median PFS was 22.3 months in the high expression group and 17.5 months in the low expression group.The high expression group was significantly better than the low expression group(P=0.034),and the difference was statistically significant.Meanwhile,the expression of PDCD4 in cancer tissue was positively correlated with PFS in esophageal cancer patients during r-sensitization(r=0.361,P=0.004).The difference was statistically significant.Conclusion:The expression of PDCD4 plays a certain role in the sensitization of tetrandrine.The high expression of patients with radio

关 键 词：汉防己甲素 放疗敏感性 PDCD4 

分 类 号：R735.1[医药卫生—肿瘤]