FDXR联合Nrf2预测食管癌新辅助放化疗的敏感性研究  

FDXR and Nrf2 expression as predictive biomarkers for therapeutic response to chemoradiation in esophageal squamous cell carcinoma:A triple-center prospective clinical trial

作　　者：刘洪 赵红珂 覃胜[4] 侯俊[4] 李丹[4] 李华 郑茂嘉 陈晶[4] LIU Hong;ZHAO Hongke;QIN Sheng;HOU Jun;LI Dan;LI Hua;ZHENG Maojia;CHEN Jing(Chengdu BOE Hospital,Sichuan Chengdu 610000,China;Jiangyou Second People's Hospital,Sichuan Jiangyou 621071,China;The First Affiliated Hospital of Xinxiang Medical College,Henan Xinxiang 453100,China;Sichuan Cancer Hospital,Electronic Medical Sciences Affiliated Cancer Hospital,Sichuan Chengdu 610073,China)

机构地区：[1]成都京东方医院,四川成都610000 [2]江油市第二人民医院,四川江油621071 [3]新乡医学院第一附属医院,河南新乡453100 [4]四川省肿瘤医院电子医学科学附属肿瘤医院,四川成都610073

出　　处：《现代肿瘤医学》2023年第18期3395-3399,共5页Journal of Modern Oncology

基　　金：四川省卫生健康委员会科研课题(编号:17PJ597)。

摘　　要：目的:探索联合FDXR和Nrf2两个生物标记物是否可以提高食管癌对放化疗敏感性预测的准确性。方法:我们前瞻性的研究,预期纳入150例食管胸段确诊为鳞癌的患者,临床分期限定为Ⅱ-Ⅲ期(AJCC第八版),在同一个活检样本中染色FDXR和Nrf2,根据FDXR和Nrf2是否表达关联术后病理学上的缓解来推测这两个生物标记物联合是否会提高判断放化疗敏感的准确性。结果:研究期间,我们收集到326个病例,其中可纳入最后分析的有162个病例,162例患者经过同步放化疗后,总缓解例数105例,总的缓解率64.8%,pCR率为28.5%,病理学部分缓解率为36.3%。FDXR阳性的有效率为42.6%,Nrf2阴性的有效率为34.6%,FDXR阳性合并Nrf2阴性患者有效率为76.8%。单因素分析显示肿瘤的T分期(P=0.04),病理分级(P=0.04)以及FDXR(P=0.02)和Nrf2(P=0.01)影响放化疗疗效,而多因素分析显示病理学分级(P=0.033)、FDXR(P=0.021)和Nrf2(P=0.034)是影响放化疗疗效独立的预后因素。结论:FDXR和Nrf2联合可以提高食管癌术前放化疗疗效预测的准确性。Objective:To investigate the predictive value of FDXR and Nrf2 expression in chemoradiotherapy response of ESCC.Methods:A total of 150 patients with pathologically confirmed stage II-III ESCC from two cancer centers were included in this prospective study.FDXR and Nrf2 expression levels were assayed using immunohistochemistry.The FDXR and Nrf2 expression and the response to chemoradiotherapy were analyzed.Results:During the study,we collected 326 cases,of which 162 cases could be included in the final analysis.After concurrent chemoradiotherapy,the total response rate of 162 patients was 105,with a total response rate of 64.8%,a pCR rate of 28.5%,and a pathological partial response rate of 36.3%.The effective rate of FDXR positive patients was 42.6%,the effective rate of Nrf2 negative patients was 34.6,and the effective rate of FDXR positive patients combined with Nrf2 negative patients was 76.8%.In 162 cases,univariate analysis showed that tumor T stage,pathological grade,FDXR and Nrf2 affected the efficacy of radiotherapy and chemotherapy,while pathological grade,FDXR and Nrf2 were independent prognostic factors affecting the efficacy of radiotherapy and chemotherapy.Conclusion:Pathological grading of esophageal squamous cell carcinoma combined with FDXR and Nrf2 can effectively predict the sensitivity of radiotherapy and chemotherapy for esophageal carcinoma.

关 键 词：生物标记物 FDXR NRF2 食管癌 

分 类 号：R735.1[医药卫生—肿瘤]