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目的:研究食管癌中C-erbB-2,bcl-2,mdr-1表达与其同步放化疗疗效及预后的相关性。方法:应用免疫组化技术(S-P法)对187例食管鳞癌进行初治前、治疗后复发或转移不同阶段胃镜活检标本中C-erbB-2,bcl-2,mdr-1三种基因蛋白表达的检测。初治均按拟定的统一放化疗方案进行:DF方案化疗同步超分割放疗。结果:187例食管鳞癌细胞中,C-erbB-2,bcl-2,mdr-1阳性表达分别为48.7%,55.1%和42.2%,治疗后完全缓解68例(36.4%),部分缓解81例(43.3%),稳定31例(16.6%),进展7例(3.7%)。C-erbB-2阴性者疾病进展时间在24~36个月者38例(39.6%),<12个月者占19.7%;C-erbB-2阳性者,疾病进展时间<12个月者比例较高;强阳性者所占比例最高达18/42(42.9%)。C-erbB-2与mdr-1同时阳性表达疾病进展时间<12个月者比例较高(45.7%);二者均阴性疾病进展时间在24~36个月所占比例较高(46.2%)。bcl-2强阳性完全缓解占21.3%,阴性完全缓解达50.0%。结论:本实验有希望为食管癌不同阶段制定个体化治疗方案,为观察疗效和预后提供更科学合理的依据。
OBJECTIVE: To study the correlation between the expression of C-erbB-2, bcl-2 and mdr-1 in esophageal carcinoma and the efficacy and prognosis of concurrent chemoradiotherapy. Methods: The expressions of C-erbB-2, bcl-2 and mdr-1 proteins in different stages of gastroscope biopsy specimens of 187 cases of esophageal squamous cell carcinoma before and after relapse or metastasis were detected by immunohistochemistry (SP method) Detection of expression. The initial treatment according to the proposed unified radiotherapy and chemotherapy program: DF regimen chemotherapy hyperfractionated radiotherapy. Results: The positive expression rates of C-erbB-2, bcl-2 and mdr-1 in 48 cases of esophageal squamous cell carcinoma were 48.7%, 55.1% and 42.2% respectively, and 68 cases (36.4% Cases (43.3%), stable in 31 cases (16.6%), progress in 7 cases (3.7%). C-erbB-2 negative disease progression in 24 to 36 months were 38 cases (39.6%), <12 months accounted for 19.7%; C-erbB-2-positive disease progression time <12 months High; strong positive proportion up to 18/42 (42.9%). The positive rate of C-erbB-2 and mdr-1 expression was higher in patients who were less than 12 months (45.7%). Both patients had a higher proportion of negative disease progression (46.2%) in 24-36 months . Complete positive bcl-2 positive response was 21.3% and negative complete response was 50.0%. Conclusion: This experiment is promising for the development of individualized treatment for different stages of esophageal cancer, to provide a more scientific and rational basis for the observation of efficacy and prognosis.