Rap80在局部晚期鼻咽癌中的表达及其临床意义

目的:探讨局部晚期鼻咽癌(nasopharyngeal carcinoma,NPC)患者肿瘤组织中受体相关蛋白80(receptor-associated protein 80,Rap80)mRNA的表达及其与西妥昔单抗联合放化疗治疗疗效的关系。方法:收集2005年1月至2008年10月在我院诊治的NPC患者111例,采用Real-time PCR检测NPC患者瘤组织中Rap80 mRNA的表达,采用log-rank检验分析Rap80 mRNA的表达与NPC患者的生存期和无进展生存期的相关性。Cox’s回归模型作多因素预后分析。结果:NPC患者中Rap80 mRNA表达水平<0.79(低表达)38例,中位生存时间36个月,死亡的风险比为0.75(p=O.56),3年总生存率42.7%;而Rap80 mRNA表达水平0.79~1.41(中表达)的患者40例,中位生存时间33个月(95%CI=19.1-36.8),死亡风险比为1,3年总生存率28.25%;Rap80 mRNA表达>1.41(高表达)的患者33例,中位生存时间26.5个月,死亡风险比为2.49(P=0.037),3年总生存率14.4%。Rap80 mRNA水平显著影响死亡率(风险比4.527,P<0.001)和无进展生存期(风险比3.582,P<0.001)。Cox’s回归分析显示,Rap80 mRNA为独立预后影响预后因素。结论:Rap80mRNA的表达与中位生存时间,死亡的风险比及3年总生存率显著相关,可作为预测预后的一个重要指标。

Expression of Rap80 mRNA and Its clinical significance in patients with locoregionally advanced nasopharyngeal carcinoma

Objective：To explore the expression of mRNA level of receptor-associated protein 80 （Rap80） and its relationship with the efficacy of combination of cetuximab and chemoradiotherapy treatment in patients with locoregionally advanced nasopharyngeal carcinoma （NPC）. Methods： One hundred and eleven cases of NPC patients collected during January 2005 to October 2008 from our hospital were enrolled in this study. The mRNA expression level of Rap80 in tumor tissue of NPC patients was measured by real-time PCR. The association between the mRNA levels of Rap80 and the efficacy of cetuximab plus cisplatin/5-Fu were analyzed with log-rank test and Chi-square test. Results：The median overall survival was 36 months and the hazard ratio （HR） was 0.75 （p=0.56） among patients with low level; 33 months and the HR of death was 1 among patients with intermediate levels, and 26.5 months and the HR of death was 2.49 （p=0.037） among patients with high levels of Rap 80 mRNA, showing a statistically significant difference in survival rate. Furthermore, the Rap80 mRNA levels could significantly affect the risk of mortality （HR： 4.527, p〈0.001） and progression-free survival （HR： 3.582, p〈0.001）.Cox ’s regression analysis showed that Rap80 mRNA level was independent prognostic factor. Conclusion： Rap80 mRNA level was significantly correlated to the median overall survival, the HR of death and the 3-year overall survival rate, suggesting was predictive marker of long-term outcome in NPC patients treated with platinum-base chemotherapy.