直肠癌患者伊立替康化疗敏感性与拓扑异构酶1水平的关系  

Chemotherapy sensitivity of irinotecan and its relationship with topoisomerase 1 level in the patients with rectal cancer

作　　者：徐佳[1] 蔡东焱[2] 刘晓媛[1] 顾盼[1] 陈杨[1] 周少丹[1] XU Jia;CAI Dongyan;LIU Xiaoyuan;GU Pan;CHEN Yang;ZHOU Shaodan(Department of Pharmacy,Hospital Affiliated to Jiangnan University,Jiangsu Wuxi 214121,China;Department of Oncology,Hospital Affiliated to Jiangnan University,Jiangsu Wuxi 214121,China)

机构地区：[1]江南大学附属医院药学部,江苏无锡214121 [2]江南大学附属医院肿瘤内科,江苏无锡214121

出　　处：《药学服务与研究》2021年第2期91-95,共5页Pharmaceutical Care and Research

基　　金：江苏省无锡市科技计划项目(NZ2019013);无锡市卫生健康委员会科技成果与适宜技术推广项目(T201936);无锡市卫生健康委员会科研项目(ZM004)。

摘　　要：目的:探讨直肠癌患者伊立替康化疗敏感性与拓扑异构酶1(TOPO-1)水平的关系。方法:纳入江南大学附属医院2017年1月-2019年6月接受伊立替康化疗的直肠癌患者80例。收集其临床资料,包括性别、年龄、临床分期、分化程度、病理类型。化疗8个周期后观察患者的近期疗效,将治疗无效者视为伊立替康化疗不敏感,将治疗有效者视为伊立替康化疗敏感,并分为敏感组和不敏感组。患者均于入院第2天取病理组织,测定并比较两组患者的TOPO-1表达水平。绘制工作特征曲线(ROC),分析TOPO-1水平对伊立替康化疗敏感性的评估价值。分别在患者入院时和化疗8个周期后,采血检测血清糖类抗原19-9(CA19-9)和癌胚抗原(CEA)水平,比较两组患者的血清指标。经Pearson线性相关检验,分析TOPO-1水平与CA19-9和CEA血清水平的相关性。结果:在80例患者中,有32例(40.00%)部分缓解,26例(32.50%)稳定,22例(27.50%)未缓解。敏感组患者的TOPO-1表达水平显著高于不敏感组[(16.39±3.26)%vs(11.28±2.11)%,P<0.05]。TOPO-1表达评估伊立替康化疗敏感性的曲线下面积为0.780(标准误=0.054,P<0.001,95%CI:0.675~0.886)。敏感组治疗后CA19-9和CEA的血清水平显著低于本组治疗前以及不敏感组治疗后(P<0.05)。Pearson线性相关检验提示,TOPO-1水平与CA19-9和CEA的血清水平呈正相关(r=0.817,P<0.001;r=0.701,P<0.001)。结论:与伊立替康化疗不敏感的直肠癌患者相比,敏感患者的肿瘤组织中TOPO-1表达水平明显增高,且TOPO-1表达水平与CA19-9和CEA的血清水平呈正相关。Objective:To explore chemotherapy sensitivity of irinotecan and its relationship with topoisomerase 1 level in the patients with rectal cancer.Methods:Eighty patients with rectal cancer who received irinotecan chemotherapy in the Hospital Affiliated to Jiangnan University from January 2017 to June 2019 were included in the study.Clinical data,including gender,age,clinical stage,differentiation degree and pathological type were collected for study.After 8 cycles of chemotherapy,observations were made in the short-term effects of the patients.Those who failed to respond to the treatment were regarded as insensitive,and those who responded to the treatment were regarded as sensitive,and they were respectively designated as the insensitive and sensitive groups.On the 2nd day after admission,the pathological tissues of the patients were collected and the expression levels of TOPO-1 were detected and compared between the patients of the two groups.The receiver operating characteristic(ROC)curve of the patients was plotted to analyze the evaluation value of TOPO-1 in chemotherapy sensitivity of irinotecan.Serum carbohydrate antigen 19-9(CA19-9)and carcinoembryonic antigen(CEA)levels were measured at admission and after 8 cycles of chemotherapy,and the serum indexes were compared between the two groups.The correlation between TOPO-1 level and serum levels of CA19-9 and CEA was analyzed by Pearson linear correlation.Results:Of the 80 patients,32(40.00%)were partially remittent,26 patients(32.50%)were stable and 22 patients(27.50%)were without remission.The expression level of TOPO-1 in the sensitive group was significantly higher than that in the insensitive group[(16.39±3.26)%vs(11.28±2.11)%,(P<0.05)].The area under the curve of TOPO-1 expression for the evaluation of chemotherapy sensitivity to irinotecan was 0.780(standard error=0.054,P<0.001,95%CI:0.675-0.886).The serum levels of CA19-9 and CEA in the sensitive group were significantly lower than those before treatment,and also lower than those in the insensitive gr

关 键 词：拓扑异构酶1 直肠癌 伊立替康 敏感性 

分 类 号：R979.1[医药卫生—药品]