β-tubulin Ⅲ在食管癌中的表达及在个体化化疗方案中的作用

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目的:探讨β-tubulin Ⅲ在食管癌组织中的表达,分析其与食管癌生物学行为的关系,及根据其表达结果制定个体化化疗方案的疗效。方法:应用免疫组化(SP)法检测β-tubulin Ⅲ在55例食管癌组织中的阳性表达,采用x2检验方法分析其阳性表达与肿瘤临床病理学特征之间的关系。依据低表达(阴性)对紫杉类抗微管药物相对敏感,选用紫杉醇联合顺铂方案;高表达(阳性)相对不敏感的原则,选择吉西他滨联合顺铂方案。对照组选用紫杉醇联合顺铂化疗方案。比较两组客观缓解率(ORR)及疾病控制率(DCR)的差异,及无进展生存时间(PFS)和中位生存期(MST)的差异。结果:β-tubulin Ⅲ在55例食管癌组织中阳性表达为16例(29.09%),在肿瘤组织中的表达与食管癌的浸润深度、淋巴结转移及肿瘤分期相关(P<0.05),而与年龄、性别、组织学分化程度无关(P>0.05)。实验组ORR为54.55%(30/55)优于对照组32.50%(13/40),x2=4.543,P=0.033;DCR为69.09%(38/55)优于对照组47.50%(19/40),x2=4.498,P=0.034。差异有统计学意义。实验组与对照组的PFS分别为5.2月和4.5月(x2=4.215,P=0.040),MST分别为8.9月和7.4月(x2=6.146,P=0.013),差异有统计学意义。结论:食管癌细胞存在β-tubulinⅢ的表达,且与肿瘤细胞的浸润深度、淋巴结转移及临床分期相关。检肿瘤标本中β-tubulinⅢ的表达,有助于为实施个体化化疗提供一种选择药物的方法。 OBJECTIVE: To investigate the expression of β-tubulin Ⅲ in esophageal carcinoma and its relationship with the biological behavior of esophageal carcinoma and to establish the curative effect of individualized chemotherapy based on its expression. Methods: The positive expression of β-tubulin Ⅲ in 55 cases of esophageal cancer tissues was detected by immunohistochemistry (SP) method. The relationship between the positive expression and clinicopathological features was analyzed by x2 test. Based on the low expression (negative) of taxane anti-microtubule drugs are relatively sensitive to choose paclitaxel combined with cisplatin program; high expression (positive) is relatively insensitive to the principle of choice gemcitabine combined with cisplatin program. The control group used paclitaxel combined with cisplatin chemotherapy. The differences of Objective Remission Rate (ORR) and Disease Control Rate (DCR) between the two groups were compared, and the differences of progression-free survival time (PFS) and median survival time (MST) were compared. Results: The positive expression of β-tubulin Ⅲ in 55 cases of esophageal carcinoma was 16 cases (29.09%). The expression of β-tubulin Ⅲ in esophageal squamous cell carcinoma was related to the depth of invasion, lymph node metastasis and tumor stage (P <0.05) Age, gender, histological differentiation had no correlation (P> 0.05). The ORR of the experimental group was significantly higher than that of the control group (54.55% (30/55), 32.50% (13/40), x2 = 4.543, P = 0.033, and DCR was 69.09% ), x2 = 4.498, P = 0.034. The difference was statistically significant. The PFS of the experimental group and the control group were 5.2 months and 4.5 months respectively (x2 = 4.215, P = 0.040), and the MST were 8.9 and 7.4 months respectively (x2 = 6.146, P = 0.013). The difference was statistically significant. Conclusion: The expression of β-tubulinⅢ in esophageal cancer cells is related to the depth of tumor invasion, lymph node metastasis and clinical stage. The detection of β-tubulinⅢ in tumor samples helps to provide a method of selecting drugs for the implementation of personalized chemotherapy.
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