表皮生长因子受体表达、肿瘤残留与鼻咽癌疗效的关系

目的 探讨同期放化疗治疗鼻咽癌表皮生长因子受体(EGFR)的表达和肿瘤残留情况对疗效和预后判断的价值.方法 200例鼻咽癌(NPC)患者应用免疫组织化学技术检测EGFR在癌组织中的表达,并分析鼻咽部及颈部肿瘤残留情况.结果 EGFR在200例NPC中阳性表达160例(80.0%),阴性表达40例(20.0%);EGFR阳性组和阴性组3年总生存率(OS)、无瘤生存率(DFS)、无区域复发生存率(LRFS)、无远处转移生存率(DMFS)分别为72.3%、63.6%、72.2%、63.8%和90.0%、90.0%、90.0%、90.0%(X2=3.95,X2=4.12,X2=3.98,X2=4.15,P＜0.05);有残留者局部复发率、远处转移率26.6%、32.5%明显高于无残留者8.1%、18.1%(X2=4.75,X2=4.94,P＜0.05);在多因素分析中,EGFR高表达与无病生存率(DFS)和总生存率(OS)显著相关(r=6.457,P＜0.05).结论 EGFR在HNC中表达率较高,过度表达者呈现不良预后的趋势;放射治疗后肿瘤残留可作为判断预后的一个指标.

Relationship betwwen epidermal growth factor, residual and curative effect in patients with nasopharyngeal cancer

Objective To investigate epidermal growth factor receptor(EGFR)expression and tumor residual to the prognostic value in patients with nasopharyngeal cancer(NPC).Methods 200 patients with NPC were examined for EGFR expression by immunohistochemistry analysis,neck cancer and nasopharyngeal residual.Results In 200 cases with NPC,expression of EGFR of positive and negative were 160 cases(80.0%) and 40 cases (20.0%);the rate of overall survival(OS),disease-free survival (DFS),loeoregional relapse-free survival (LRFS) and distant metastasis-free survival(DMFS)in patients with positive EGFR were 72.3%,63.6%,72.2%,63.8% and negative EGFR were 90.0%,90.0%,90.0%,90.0%,respectively in 3-year(X2=3.95,X2=4.12,X2=3.98,X2=4.15,P＜0.05),the rate of local recurrence,distant metastasis rate in residual were 26.6%,32.5% which is significantly higher than 8.1%,18.1% in without residual(X2=4.75,X2=4.94,P＜0.05);the hish expression of EGFR with DFS,OS were significantly correlated(r=6.457,P＜0.05).Conclusion The overexpress of EGFR had the tendency of poor prognosis.tumor residual after radiotherpy can be a prognostic indicator for patients with NPC.