ATP-TCA、常见耐药蛋白表达与IB3~IIB期宫颈癌新辅助化疗疗效的关系  

Correlation of ATP-TCA,expression of drug resistance protein and short-term efficacy of neoadjuvant chemotherapy for stage IB3-IIB cervical cancer

作　　者：宋丹[1] 孔为民[1] 韩超[1] 李静[1] 赵轩宇[1] SONG Dan;KONG Weimin;HAN Chao;LI Jing;ZHAO Xuanyu(Department of Gynecological Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100006, China)

机构地区：[1]首都医科大学附属北京妇产医院妇瘤科,北京100006

出　　处：《临床肿瘤学杂志》2020年第7期619-624,共6页Chinese Clinical Oncology

基　　金：北京市科学技术委员会首都市民健康项目培育课题(Z151100003915149)。

摘　　要：目的评价联合三磷酸腺苷-肿瘤体外药敏检测技术(ATP-TCA)和常见耐药蛋白检测两种方法预测宫颈癌化疗敏感性的可行性。方法收集2014年12月至2017年12月接受治疗前IB3~IIB期(根据FIGO 2018标准重新分期)宫颈鳞癌患者的新鲜肿瘤组织标本100例。采用ATP-TCA对宫颈癌细胞进行体外药敏检测。同时采用En Vision免疫组化法检测P-gp、GST-π、TopoⅡ和TS 4种蛋白的表达。标本取材后,患者均接受紫杉醇+卡铂方案新辅助化疗2个周期。评价新辅助化疗的近期疗效以及两种检测方法联合预测临床化疗敏感性的可行性。结果(1)95例患者完成ATP-TCA体外药敏检测,紫杉醇+卡铂方案的体外有效率达80.0%。95例患者中获CR 5例,PR 68例,有效率为76.8%。体外药敏试验结果与近期疗效的符合率为86.3%,其预测临床化疗敏感性的灵敏度和特异度分别为93.2%和63.6%。(2)P-gp、GST-π、TopoⅡ和TS蛋白的阳性表达率分别为42.1%(40/95)、28.4%(27/95)、33.7%(32/95)和55.8%(53/95)。耐药蛋白P-gp、GST-π和TopoⅡ表达与近期疗效有关(P<0.05)。GST-π表达与近期疗效符合率最高,为75.8%;其预测临床化疗敏感性的灵敏度、特异度分别为80.8%和59.1%。(3)仅耐药蛋白GST-π与ATP-TCA检测结果有关(P<0.05),两者符合率达81.0%。(4)耐药蛋白GST-π表达联合体外药敏试验与近期疗效的符合率最高,为87.4%。结论ATP-TCA体外药敏试验联合耐药蛋白GST-π表达能够预测宫颈癌化疗的敏感性,为实现宫颈癌同步放化疗化疗药物的个体化选择提供参考。Objective To investigate the predictive significance of ATP-tumor chemosensitivity assay(ATP-TCA)in combination with drug resistance protein for stage IB3-IIB cervical cancer applied with chemotherapy.Methods From December 2014 to December 2017,100 cases of stage IB3-IIB cervical squamous cancer(re-staging according to the staging criteria of cervical cancer FIGO 2018)were collected before treatment.En Vision immunohistochemistry was used to analyze P-gp,GST-π,TopoⅡand TS expression.ATP-TCA method was used to detect the drug sensitivity of cervical cancer cells in vitro.The patients received paclitaxel(PTX)+carboplatin(CBP)neoadjuvant chemotherapy for 2 cycles after taking samples.The short-term efficacy of neoadjuvant chemotherapy and the feasibility of combining the two detection were analyzed.Results(1)Ninety-five patients completed ATP-TCA in vitro drug sensitivity test,the effective rate of PTX+CBP regimen was 80.0%.There were 5 patients with complete response(CR)and 68 patients with partial response(PR),and the effective rate was 76.8%.The coincidence rate between the results of in vitro drug sensitivity test and short-term efficacy was 86.3%,and the sensitivity and specificity of in vitro drug sensitivity test for short-term efficacy were 93.2%and 63.6%,respectively.(2)The positive expression of P-gp,GST-π,TopoⅡand TS were 42.1%(40/95),28.4%(27/95),33.7%(32/95)and 55.8%(53/95),respectively.The expression of P-gp,GST-πand TopoⅡin cervical squamous cancer was associated with the short-term efficacy(P<0.05).The coincidence rate between the results of GST-πexpression and short-term efficacy was the highest(75.8%),and the predictive sensitivity and specificity for short-term efficacy were 80.8%and 59.1%,respectively.(3)The result of ATP-TCA was associated with drug resistance protein GST-πonly(P<0.05).The coincidence rate between the detection of drug resistance protein GST-πwith ATP-TCA was 81.0%.(4)ATP-TCA combined with drug resistance protein GST-πhad the best coincidence rate up to 87.4%.Conclu

关 键 词：宫颈癌 三磷酸腺苷-肿瘤体外药敏检测技术(ATP-TCA) 耐药蛋白 近期疗效 

分 类 号：R737.33[医药卫生—肿瘤]