摘要
目的：探讨PTNE蛋白表达对于西妥昔单抗联合化疗治疗转移性结直肠癌疗效的影响。方法初诊的晚期结直肠癌患者，共纳入经分子病理学证实KRAS野生型、同时接受过西妥昔单抗联合化疗的患者共51例，应用免疫组织化学法（ S－P法）检测肿瘤组织中PTEN蛋白的表达。分析PTNE蛋白表达与患者临床病理特征及疗效的关系。结果51例患者中，25例患者一线接受了西妥昔单抗联合化疗，26例患者二线接受了西妥昔单抗联合化疗。25例患者获得部分缓解（PR），占49．0％；19例患者病情稳定（SD），占37．3％；疾病控制率（DCR）86．3％。中位生存时间22．0个月。 PTEN阳性表达30例（58．8％）。 PTEN表达与病理分级有关（P＝0．015）；PTEN阳性的患者DCR 93．3％（28／30），PTEN阴性者DCR 66．7％（14／21），PTEN表达与DCR有关（P＝0．035）。单因素分析显示，不同ECOG PS评分、PTEN状态对中位总生存时间（OS）的影响差异有统计学意义（P＝0．032，P＝0．026）；Cox多因素分析提示ECOG PS评分及PTEN状态是晚期KRAS野生型的结直肠癌患者接受西妥昔单抗治疗独立疗效预后因素。结论 KARS野生型晚期结直肠癌患者PTEN蛋白检测可能有助于预测西妥昔单抗联合化疗的疗效。
Objective To determine the relationship between the level of phosphatase and tensin homolog deleted on chromosome ten （ PTEN） and the efficacy of cetuximab in combined with chemotherapy to treat metastatic colorectal canc-er （ mCRC） .Methods A total of 51 mCRC patients who were initially diagnosed in our hospital from January 2007 to December 2012 were included in the current study.They were identified as wild-type KRAS carriers and treated with cetuximab in combination with chemotherapy.Then, the levels of PTEN in tumor tissues were determined by immunohis-tochemistry （ IHC） .Results Among these patients were 25 patients who received first-line cetuximab combined with chemotherapy, and 26 patients who underwent second -line cetuximab combined with chemotherapy.The partial re-sponse （PR） rate was 49.0% （25/51）.There were 19 patients with stable disease （SD）.The disease control rate （DCR） was 86.3%（44/51）.The median overall survival was 22.0 months.The positive expression rate of PTEN was 58.8%（30/51）, which was correlated with histological grade （P=0.015）.The DCR was 93.3%（28/30） for PTEN positive patients and 66.7% （14/21） for PTEN negative patients.The quantity of PTEN was related with DCR （ P=0.035）.According to analysis of variance, the effects of RCOG performance status （PS） scores and PTEN level on me-dian overall survival were statistically different （P=0.032 and P=0.026, respectively）.Multivariate COX regression a-nalysis showed that ECOG PS scores and PTEN level were independent prognostic factors for mCRC patients with wild-type KRAS receiving cetuximab combined with chemotherapy.Conclusion Detection of PTEN in mCRC patients with wild-type KRAS is beneficial for predicting the efficacy of cetuximab combined with chemotherapy.
出处
《徐州医学院学报》
CAS
2015年第10期667-672,共6页
Acta Academiae Medicinae Xuzhou
基金
福建省自然科学基金面上项目（2014J01298）
国家临床重点专科建设项目
