鼻咽癌组织中EGFR和nm23表达对患者预后的预测价值研究

发布时间：2018-04-23 12:39

  本文选题：鼻咽肿瘤 + 表皮生长因子受体　； 参考：《济南大学》2011年硕士论文

【摘要】：目的:生物分子标志物已经广泛应用于肿瘤的诊断、分期及判断复发等,并且已有研究表明治疗前分子标志物的表达能够预测多种肿瘤的疗效和预后。为进一步提高鼻咽癌患者的疗效,探讨有效分子标记物表皮生长因子受体(EGFR)和转移抑制基因(nm23)表达与鼻咽癌(NPC)患者放疗敏感性及预后的相关性,为评估其对鼻咽癌患者预后的预测价值提供可靠的临床依据,并指导靶向药物等个体化治疗方案的选择。 方法:回顾分析本院2003—2006年放疗前行鼻咽活检且资料完整的127例经病理证实的鼻咽癌患者,所有患者均采用6MV X线调强适形放疗联合顺铂+氟尿嘧啶方案化疗。采用免疫组化链霉素抗生物素蛋白-过氧化物酶法(SP)检测活检标本中EGFR和nm23表达,随访5年并用Kaplan-Meier法、Log-rank检验分析EGFR、nm23表达与局部晚期鼻咽癌患者预后的关系。 结果:EGFR和nm23在鼻咽癌活检标本中的阳性表达率分别为80.3%和47.2%。EGFR不同表达与鼻咽癌患者放疗敏感性相关(χ2=5.19,P=0.023)。nm23不同表达与鼻咽癌患者发生远处转移相关(χ2=7.03,P=0.008)。全组患者5年局部控制率、总生存率(OS)、无瘤生存率(DFS)分别为58.3%、53.5%、46.5%。EGFR阴性者5年OS、DFS比阳性者高(χ2=8.23,P=0.004;χ2=5.25,P=0.022),nm23阳性者5年OS、DFS均比阴性者高(χ2=15.68,P=0.000;χ2=14.85,P=0.000)。Cox回归模型多因素分析显示分期、EGFR及nm23表达均可作为判断鼻咽癌患者预后的因素(χ2=23.027、18.331、39.916,P=0.000、0.000、0.000)。 结论:放疗前EGFR和nm23表达与鼻咽癌患者预后密切相关,可作为预测鼻咽癌患者的预后因素,指导临床治疗方案的选择;其中EGFR表达阳性者及nm23表达阴性者预后较差,需配合靶向药物等更积极的治疗。
[Abstract]:Objective: biomolecular markers have been widely used in the diagnosis, staging and recurrence of tumors, and it has been shown that the expression of molecular markers before treatment can predict the curative effect and prognosis of many kinds of tumors. In order to improve the curative effect of nasopharyngeal carcinoma (NPC) patients, the expression of epidermal growth factor receptor (EGFR) and metastasis suppressor gene (nm23) was investigated in patients with nasopharyngeal carcinoma (NPC). In order to evaluate the prognostic value of nasopharyngeal carcinoma (NPC) patients, it can provide reliable clinical basis and guide the choice of individualized treatment schemes such as targeted drugs. Methods: a total of 127 patients with nasopharyngeal carcinoma confirmed by pathology before radiotherapy from 2003 to 2006 were retrospectively analyzed. All patients were treated with 6MV intensity modulated radiotherapy combined with cisplatin fluorouracil regimen. The expression of EGFR and nm23 in biopsy specimens was detected by immunohistochemical streptomycin avidin-peroxidase method. The relationship between the expression of EGFR rnm23 and the prognosis of locally advanced nasopharyngeal carcinoma was analyzed by Kaplan-Meier log-rank test for 5 years. Results the positive rates of nm23 and nm23 in NPC biopsy specimens were 80.3% and 80.3%, respectively. The different expression of 47.2%.EGFR was correlated with the radiosensitivity of NPC patients (蠂 ~ 2 / 5.19) and the distant metastasis of NPC (蠂 ~ 2 / 7.03 P ~ (0.008) P ~ (0.008)). The 5-year local control rate of all patients, 鎬荤敓瀛樼巼(OS),鏃犵槫鐢熷瓨鐜，

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