英國(guó)諾丁漢大學(xué)一研究小組在最近一期的《英國(guó)癌癥研究期刊》上發(fā)表論文稱,，使用免疫組織化學(xué)染色法來(lái)對(duì)腫瘤退化及ERCC1核蛋白表達(dá)進(jìn)行評(píng)估,，是對(duì)接受輔助性化療手段的賁門癌患者進(jìn)行病情實(shí)時(shí)監(jiān)測(cè)的有效辦法。該發(fā)現(xiàn)或?qū)ξ磥?lái)賁門癌的臨床治療產(chǎn)生重大影響,，從而給患者帶來(lái)新的希望,。
賁門癌是一種特殊類型的胃癌，腫瘤產(chǎn)生于食管與胃部的連接部位,，也稱胃—食管連接部癌,。該種癌癥與其他部位的胃癌不同，具有自己的組織學(xué)特性和臨床表現(xiàn),，其診斷和治療方法較為獨(dú)特,，外科治療效果也比較差，目前還沒有患者能在診斷出該種疾病后活過5年?，F(xiàn)在較為流行的標(biāo)準(zhǔn)治療方案是先對(duì)患者進(jìn)行12周的高強(qiáng)度化療,，然后進(jìn)行外科手術(shù)，之后再做為期12周的化療,。實(shí)踐表明,，該治療方案的效果并不明顯，長(zhǎng)時(shí)間的化療不僅對(duì)病人的身體有極大影響,，且只對(duì)那些對(duì)化療有反應(yīng)的病人有作用,。
英國(guó)諾丁漢大學(xué)及該校附屬醫(yī)院的專家組成的賁門癌研究小組，在過去5年一直致力于該種疾病的研究,，希望能找到改進(jìn)該疾病治療方法的手段,。他們?cè)谘芯空撐闹兄赋觯ㄟ^免疫組織化學(xué)染色法,，可以對(duì)賁門癌患者的腫瘤退化及ERCC1核蛋白表達(dá)情況進(jìn)行實(shí)時(shí)監(jiān)控,，使醫(yī)生能夠在治療期間對(duì)腫瘤的發(fā)展情況進(jìn)行評(píng)估，從而幫助其決斷是否采用后續(xù)的化療手段,。他們進(jìn)行的實(shí)驗(yàn)驗(yàn)證了該種方法的有效性,，對(duì)大約250名患者手術(shù)后的腫瘤樣本進(jìn)行的分析顯示,，術(shù)后化療只對(duì)40%至50%的患者起作用。
研究人員認(rèn)為,，新發(fā)現(xiàn)可使醫(yī)生能夠判定在手術(shù)后進(jìn)行第二次化療的必要性,，從而為賁門癌患者提供更合適的治療手段，同時(shí)也為進(jìn)行更廣泛,、專業(yè)的臨床研究鋪平了道路,，將對(duì)未來(lái)該種癌癥的臨床治療產(chǎn)生重大影響。
隨著人們飲食習(xí)慣和生活方式的改變,，賁門癌的發(fā)病率呈逐漸增長(zhǎng)之勢(shì),。英國(guó)人的賁門癌發(fā)病率是世界上所有白人里最高的。據(jù)英國(guó)癌癥研究中心統(tǒng)計(jì),，自20世紀(jì)70年代以來(lái),該種癌癥在英國(guó)男性中的發(fā)病率增加了50%，在女性中增加了20%,。而在我國(guó),，賁門癌的發(fā)病率和死亡率在各類惡性腫瘤中也位居前列。(生物谷Bioon.com)
生物谷推薦原文出處：
British Journal of Cancer doi:10.1038/sj.bjc.6605686
Tumour regression and ERCC1 nuclear protein expression predict clinical outcome in patients with gastro-oesophageal cancer treated with neoadjuvant chemotherapy
K R Fareed, A Al-Attar, I N Soomro, P V Kaye, J Patel, D N Lobo, S L Parsons and S Madhusudan
Aims:
Neoadjuvant chemotherapy followed by surgery is the standard of care for patients with gastro-oesophageal adenocarcinoma. Previously, we validated the utility of the tumour regression grade (TRG) as a histopathological marker of tumour downstaging in patients receiving platinum-based neoadjuvant chemotherapy. In this study we profiled key DNA repair and damage signalling factors and correlated them with clinicopathological outcomes, including TRG response.
Methods and results:
Formalin-fixed human gastro-oesophageal cancers were constructed into tissue microarrays (TMAs). The first set consisted of 142 gastric/gastro-oesophageal cancer cases not exposed to neoadjuvant chemotherapy and the second set consisted of 103 gastric/gastro-oesophageal cancer cases exposed to preoperative platinum-based chemotherapy. Expressions of ERCC1, XPF, FANCD2, APE1 and p53 were investigated using immunohistochemistry.
In patients who received neoadjuvant chemotherapy, favourable TRG response (TRG 1, 2 or 3) was associated with improvement in disease-specific survival (P=0.038). ERCC1 nuclear expression correlated with lack of histopathological response (TRG 4 or 5) to neoadjuvant chemotherapy (P=0.006) and was associated with poor disease-specific (P=0.020) and overall survival (P=0.040).
Conclusions:
We provide evidence that tumour regression and ERCC1 nuclear protein expression evaluated by immunohistochemistry are promising predictive markers in gastro-oesophageal cancer patients receiving neoadjuvant platinum-based chemotherapy.
