APAF-1和COX-2表达程度与局部晚期直肠癌neo-CRT后pCR相关性研究

目的 探讨局部晚期直肠癌组织中APAF-1、COX-2表达程度与新辅助同期neo-CRT后pCR相关性。方法 收集2005—2012年行neo-CRT及根治性手术的82例局部晚期直肠癌疗前癌组织石蜡包埋切片,采用免疫组化法评估APAF-1、COX-2表达水平。复阅术后病理组织切片,评估放化疗后肿瘤退缩等级(0—4级,pCR为4级)。分析APAF-1、COX-2表达程度与pCR是否相关。χ²检验或 Fisher’s精确概率法检验。结果 neo-CRT后0、1、2、3、4级分别为0、6(7%)、33(40%)、20(24%)、23(28%)例。APAF-1高表达组pCR率高于低表达组(37%∶17%,P=0.047),COX-2低表达组pCR率高于高表达组(38%∶15%,P=0.028)。APAF-1高表达/COX-2低表达组pCR率高于APAF-1高表达/COX-2高表达组、APAF-1低表达/COX-2低表达组、APAF-1低表达/COX-2高表达组(56%、14%、17%、15%,P=0.005)。APAF-1表达程度与pCR呈正相关(P=0.042),COX-2表达程度与pCR呈负相关(P=0.024)。

Relationship of expression of APAF-1 and COX-2 with pathologic complete response to neoadjuvant chemoradiotherapy for locally advanced rectal adenocarcinoma

Objective To investigate the relationship of expression of apoptosis protease-activating factor 1 (APAF-1) and cyclooxygenase-2(COX-2) with pathologic complete response (pCR) to neoadjuvant chemoradiotherapy (neo-CRT) for locally advanced rectal adenocarcinoma.Methods Paraffin-embedded tumor tissue sections were collected from 82 patients with locally advanced rectal adenocarcinoma who received neo-CRT and radical surgery from 2005 to 2012.Immunohistochemical assay was used to determine the expression of APAF-1 and COX-2.Postoperative pathological tissue sections were reassessed for evaluation of tumor regression grade (0-4,pC R =4) after radiochemotherapy.The relationship of expression of APAF-1 and COX-2 with pCR was analyzed by chi-square test or Fisher's exact test.Logistic regression analysis was used to predict the influencing factors for pCR.Results The numbers of patients with grade 0,1,2,3,and 4 tumor regression were 0,6 (7％),33 (40％),20 (24％),and 23 (28％),respectively.Patients with high expression of APAF-1 had a significantly higher incidence of pCR than those with low expression of APAF-1 (37％ vs.17％,P=0.047),while patients with low expression of COX-2 had a significantly higher incidence of pCR than those with high expression of COX-2(38％ vs.15％,P=0.028).Patients with high expression of APAF-1 and low expression of COX-2 had a significantly higher incidence of pCR than patients with high expression of APAF-1 and COX-2,patients with low expression of APAF-1 and COX-2,and patients with low expression of APAF-1 and high expression of COX-2(56％ vs.14％;56％ vs.17％;56％ vs.15％;P=0.005).The expression of APAF-1 was positively correlated with pCR (P=0.042),while the expression of COX-2 was negatively correlated with pCR (P=0.024).Conclusions The expression of APAF-1 and COX-2 is correlated with pCR to neo-CRT for locally advanced rectal adenocarcinoma.The measurement of expression of both APAF-1 and COX-2 holds promise for prediction of pCR.