肌层浸润性膀胱癌吉西他滨 联合顺铂新辅 助化疗前后肿瘤组织中KU蛋白表达变化及其与疗效的关系  

Changes of KU protein expression in tumor tissue before and after gemcitabine combined with cisplatin neoadjuvant chemotherapy for muscular invasive bladder cancer and its relationship with curative effect

作　　者：张林林 徐钊 董龙信 李贞 张维涛 ZHANG Linlin;XU Zhao;DONG Longxin;LI Zhen;ZHANG Weitao(Department of Urology,the Second Affiliated Hospital of Shandong First Medical University,Shandong Tai'an 271000,China;Department of Urology,Tai'an Central Hospital,Tai'an Central Hospital Affiliated to Qingdao University,Taishan Medical Care Center,Shandong Tai'an 271000,China;Department of Oncology,the Second Affiliated Hospital of Shandong First Medical University,Shandong Tai'an 271000,China)

机构地区：[1]山东第一医科大学第二附属医院泌尿外科,山东泰安271000 [2]泰安市中心医院(青岛大学附属泰安市中心医院、泰山医养中心)泌尿外科,山东泰安271000 [3]山东第一医科大学第二附属医院肿瘤科,山东泰安271000

出　　处：《现代肿瘤医学》2024年第21期4143-4148,共6页Journal of Modern Oncology

基　　金：山东省泰安市科技创新发展项目(政策引导类)(编号:2022NS202)。

摘　　要：目的:观察KU蛋白在肌层浸润性膀胱癌新辅助化疗前、后肿瘤组织中的表达变化,探讨其与新辅助化疗疗效的关系。方法:回顾性研究山东第一医科大学第二附属医院与泰安市中心医院(青岛大学附属泰安市中心医院、泰山医养中心)2012年07月至2023年07月接受术前新辅助化疗的54例T 2N 0M 0-T 4a N 0M 0期肌层浸润性膀胱癌患者的临床资料。54例患者均采用吉西他滨联合顺铂术前新辅助化疗,21 d为1个周期,疗程2~4个周期,根据疗效将患者分为完全缓解组、部分缓解组、疾病稳定组和疾病进展组。免疫组化法检测各组患者新辅助化疗前、后肿瘤组织中KU蛋白表达变化,观察KU蛋白表达变化与新辅助化疗疗效的关系。结果:54例患者均完成新辅助化疗,平均疗程为3个周期,其中部分缓解组占50.0%(27/54),新辅助化疗后KU蛋白在该组患者癌组织中表达显著降低,差异具有统计学意义(P<0.01);疾病稳定组占29.6%(16/54),新辅助化疗后KU蛋白在该组患者癌组织中表达降低,差异具有统计学意义(P<0.05);疾病进展组占13.0%(7/54),新辅助化疗后KU蛋白在该组患者癌组织中表达上升,差异无统计学意义(P>0.05)。结论:KU蛋白参与了肌层浸润性膀胱癌新辅助化疗反应过程,新辅助化疗后肿瘤组织中KU蛋白表达减弱,这一现象可提示新辅助化疗效果好。通过免疫组化检测KU蛋白表达变化可以作为肌层浸润性膀胱癌新辅助化疗疗效预测的一种方法。Objective:To investigate the expression of KU protein before and after neoadjuvant chemotherapy in patients with muscular invasive bladder cancer,and explore its correlation with the efficacy of neoadjuvant chemotherapy.Methods:A retrospective study was conducted on clinical data from 54 patients with stage T 2N 0M 0-T 4a N 0M 0 muscular invasive bladder cancer who underwent preoperative neoadjuvant chemotherapy at the Second Affiliated Hospital of Shandong First Medical University,Tai'an Central Hospital,and Taishan Medical Center Affiliated to Qingdao University between July 2012 and July 2023.All patients received gemcitabine combined with cisplatin for 2 to 4 cycles every 21 days.Based on treatment response,patients were categorized into complete remission group,partial remission group,stable disease group or disease progression group.Immunohistochemistry was used to detect KU protein expression in tumor tissues before and after neoadjuvant chemotherapy,and its relationship with treatment efficacy was analyzed.Results:All 54 patients completed neoadjuvant chemotherapy,with an average duration of 3 courses.Among them,50.0%(27/54)were in the partial remission group.Following neoadjuvant chemotherapy,a significant decrease in KU protein expression was observed in cancer tissues of this group(P<0.01).In the stable disease group(16/54,29.6%),there was also a statistically significant reduction in KU protein expression after neoadjuvant chemotherapy(P<0.05).However,no statistical significance was found for the increase in KU protein expression observed following neoadjuvant chemotherapy among patients in the progressive group(7/54,13.0%).Conclusion:The KU protein is implicated in the neoadjuvant chemotherapy response process for muscular invasive bladder cancer,and its expression in tumor tissues decreases following treatment,indicating the effectiveness of neoadjuvant chemotherapy.Immunohistochemical detection of KU protein expression can serve as a predictive method for assessing neoadjuvant chemotherapy efficacy

关 键 词：肌层浸润性膀胱癌 新辅助化疗 免疫组织化学 吉西他滨联合顺铂 KU蛋白 标志物 

分 类 号：R737.14[医药卫生—肿瘤]