Ki-67与直肠癌新辅助放化疗敏感性的关系  

Relationship between Ki-67 and sensitivity to neoadjuvant chemoradiotherapy for rectal cancer

作　　者：孙二峰 马相民[1] 郭成云[1] 李丁伟 陈换峰 王时俊[2] 俞强 尤晴 SUN Erfeng;MA Xiangmin;GUO Chengyun;LI Dingwei;CHEN Huanfeng;WANG Shijun;YU Qiang;YOU Qing(Department of Anorectal Surgery,Sanmenxia Central Hospital,Sanmenxia,Henan 472000,China;Department of Anorectal Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450000,China;Department of Gastrointestinal Surgery,the First Affiliated Hospital of Air Force Medical University,Xi'an,Shaanri 710000,China)

机构地区：[1]三门峡市中心医院肛肠外科,河南三门峡472000 [2]郑州大学第一附属医院肛肠外科,河南郑州450000 [3]空军军医大学第一附属医院胃肠外科,陕西西安710000

出　　处：《中华实用诊断与治疗杂志》2023年第7期669-672,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：三门峡市科技发展计划项目(2020040328)。

摘　　要：目的 观察直肠癌患者新辅助放化疗后肿瘤退缩程度与癌组织Ki-67评分变化,探讨Ki-67表达与新辅助放化疗敏感性的关系。方法 2018年10月—2023年4月三门峡市中心医院、郑州大学第一附属医院、空军军医大学第一附属医院行手术治疗的直肠癌患者45例,术前均采用长程放疗联合口服卡培他滨方案化疗。术后行组织病理检查,根据肿瘤细胞比例、瘤床及纤维化情况行肿瘤退缩分级(TRG),分级越高放化疗敏感度越低;行免疫组织化学检查测定Ki-67评分;采用Spearman相关法分析直肠癌患者新辅助放化疗后TRG与直肠癌Ki-67评分的相关性。结果 45例患者新辅助放化疗后TRG为0级4例(8.9%),1级2例(4.4%),2级26例(57.8%),3级13例(28.9%);术后Ki-67评分0分3例TRG均为0级;1分4例中TRG为2级3例、3级1例;2分11例中TRG为1级1例、2级7例、3级3例;3分17例中TRG为1级1例、2级10例、3级6例;4分10例中TRG为0级1例、2级6例、3级3例。直肠癌患者新辅助放化疗后TRG与Ki-67评分呈正相关(r=0.387,P=0.009)。结论 直肠癌患者肿瘤组织Ki-67评分较高者对新辅助放化疗不敏感,新辅助放化疗前行肠镜组织穿刺活检检测Ki-67表达可为制订个体化新辅助化疗方案提供参考。Objective To observe the degree of tumor regression and changes of Ki-67score after neoadjuvant chemoradiotherapy in patients with rectal cancer,and to explore the relationship between Ki-67expression and sensitivity to preoperative neoadjuvant chemoradiotherapy.Methods Forty-five patients with rectal cancer received operation in Sanmenxia Central Hospital,the First Affiliated Hospital of Zhengzhou University and the First Affiliated Hospital of Air Force Military Medical University from October 2018to April 2023.All patients received long-term radiotherapy combined with oral capecitabine chemotherapy before operation,and histopathological examination after operation.The tumor regression grade(TRG)was evaluated according to the proportion of tumor cells,tumor bed and fibrosis.The sensitivity to chemoradiotherapy decreased with the increase of TRG.Immunohistochemical examination was performed to score the proportion of positive cells of Ki-67.Spearman correlation was used to analyze the correlation between TRG and Ki-67score of rectal cancer after neoadjuvant chemoradiotherapy.Results In 45patients,the TRG was 0in 4patients(8.9%),1in 2patients(4.4%),2in 26patients(57.8%),and 3 in 13 patients(28.9%).The postoperative Ki-67score was 0 in 3patients with TRG 0;was 1 in 4 patients with TRG 2in 3patients and TRG 3in 1patient;was 2in 11 patients with TRG 1in 1patient,TRG 2 in 7 patients,and TRG 3in 3 patients;was 3in 17 patients with TRG 1 in 1 patient,TRG 2 in 10 patients and TRG 3 in 6patients;and was 4in 10 patients with TRG 0 in 1 patient,TRG 2 in 6patients and TRG 3 in 3patients.The TRG after neoadjuvant chemoradiotherapy was positively correlated with the Ki-67score in patients with rectal cancer(r=0.387,P=0.009).Conclusions The rectal cancer patients with high Ki-67score are not sensitive to the neoadjuvant chemoradiotherapy.To detect Ki-67 by colonoscopy biopsy immunohistochemistry examination before neoadjuvant chemoradiotherapy can provide a reference for the formulation of individualized neoadjuvant chemothera

关 键 词：直肠癌 新辅助放化疗 KI-67 放化疗敏感性 

分 类 号：R735.37[医药卫生—肿瘤]