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分子标记物预测直肠癌新辅助放化疗效果初步评价
引用本文:赵刚,王征,肖刚,修霞,孙建华,周新平,安琦,黄美雄. 分子标记物预测直肠癌新辅助放化疗效果初步评价[J]. 中国现代普通外科进展, 2011, 14(10): 768-771. DOI: 10.3969/j.issn.1009-9905.2011.10.006
作者姓名:赵刚  王征  肖刚  修霞  孙建华  周新平  安琦  黄美雄
作者单位:1. 卫生部北京医院普通外科,北京,100730
2. 卫生部北京医院病理科,北京,100730
3. 卫生部北京医院放疗科,北京,100730
摘    要:目的:寻找预测直肠癌新辅助治疗效果的分子标志物。方法:对26例行新辅助治疗的进展期中低位直肠癌的治疗前活检标本的K-ras基因进行测序,同时通过免疫组织化学方法对分子标志物增殖细胞核抗体(Ki-67)、核转录因子(NF-KB)、细胞周期蛋白依赖性激酶1(CDK1)进行检测。对手术标本行病理分析和肿瘤消退分级评估。结果:本组病例新辅助治疗后获得病理完全缓解(pCR)的患者7例(26.9%)均为K-ras基因野生型,治疗后降期患者17例(65.4%)。K-ras基因是否突变同新辅助放化疗(CRT)能否达到pCR密切相关(P=0.048)。K-ras基因野生型患者的降期率和肿瘤消退率均为77.8%(14/18),同突变型的降期率和肿瘤消退率比较P=0.063。结论:中低位直肠癌患者新辅助治疗前K-ras基因野生型可能预示着较好的新辅助治疗效果。

关 键 词:直肠肿瘤  新辅助治疗  K-ras基因  肿瘤降期

Biomarkers for response to preoperative chemoradiotherapy in patients with rectal carcinoma
ZHAO Gang,WANG Zheng,XIAO Gang,XIU Xia,SUN Jian-hua,ZHOU Xin-ping,AN Qi,HUANG Mei-xiong. Biomarkers for response to preoperative chemoradiotherapy in patients with rectal carcinoma[J]. Chinese Journal of Current Advances in General Surgery, 2011, 14(10): 768-771. DOI: 10.3969/j.issn.1009-9905.2011.10.006
Authors:ZHAO Gang  WANG Zheng  XIAO Gang  XIU Xia  SUN Jian-hua  ZHOU Xin-ping  AN Qi  HUANG Mei-xiong
Affiliation:ZHAO Gang1,WANG Zheng2,XIAO Gang1,XIU Xia3,SUN Jian-hua1,ZHOU Xin-ping1,AN Qi1,HUANG Mei-xiong1 1Department of general Surgery,2Department of Pathology,3Department of Radiotherapy,Beijing Hospital(Beijing 100730,China)
Abstract:Objective: To identify biomarkers for response to preoperative chemoradiotherapy in patients with rectal carcinoma. Methods: Twenty-six patients with mid-low rectal cancer underwent neoadjuvant before surgery were included in this study. For pretreatment tumor biopsies, K-ras was detected by Gene sequencing, Ki-67,NF-κB,CDK1 were detected by immunohistochemistry using specific antibodies. Pathology analysis and Tumor-regression grading were done after operation. Results: In this group, 7 cases (26.9%)got pCR after the neoadjuvant therapy and their K-ras were all wild type. Down-staging was achieved in 17 cases (65.4%), K-ras gene muta- tion was relevant to pCR rate (P=0.048). Down-staging rate and tumor-regression rate of patients with wild type K-ras gene were both 77.8% (14/18), which were better than down-staging rate and tumor-regression rate of patients with mutated type K-ras gene (P = 0.063). Conclusions: Our results demonstrate that wild type K-ras gene in pretreatment mid-low rectal carcinoma may be predictive of good tumor response to neoadjuvant therapy.
Keywords:Rectal neoplasms   Neoadjuvant therapy- K-ras gene  Tumor down-staging
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