AIM2表达预测直肠癌新辅助放化疗的敏感性及其与预后的关系

AIM2 expression predicts response of rectal cancers to pre-operative chemoradiotherapy and its relationship to prognosis

目的:研究AIM2的表达是否可以预测局部进展期直肠癌新辅助放化疗(neoadjuvant chemoradiotherapy,nCRT)的反应以及预后。方法:免疫组化检测122例进展期直肠癌患者肿瘤组织AIM2的表达,统计分析AIM2的表达与临床基础数据的关系。结果:26例治疗前活检组织中检测到AIM2过表达。AIM2过表达与性别(P=0.316)、年龄(P=0.283)、组织分化程度(P=0.356)、癌胚抗原(carcinoembryonic antigen,CEA)血浆水平(P=0.468)、肿瘤部位(P=0.309)、肿瘤临床分期(P=0.284)和淋巴结临床分期(P=0.264)均无关。96例手术切除标本中有65例(67.7%)AIM2过表达(P <0.001)。单因素和多因素分析显示AIM2过表达能预测局部进展期直肠癌对新辅助放化疗耐受:96.2%(25/26)的AIM2过表达直肠癌对新辅助放化疗耐受,81.3%(78/96)的AIM2正常表达或低表达直肠癌对新辅助放化疗敏感(P <0.001)。经过51个月的中位随访时间,多因素分析显示AIM2过表达的局部进展期直肠癌与患者的无复发生存(recurrence free survival,RFS)和总生存(overall survival,OS)均无显著相关(P=0.634和P=0.932)。结论:AIM2表达水平可以作为局部进展期直肠癌新辅助放化疗耐受的预测指标。AIM2信号通路拮抗剂具有成为直肠癌放化疗增敏药物的潜力。

Objective:This study was aimed to determine whether Melanoma 2(AIM2)expression predicts response to neoadjuvant chemoradiotherapy(nCRT)and outcomes for patients with locally advanced rectal cancer(LARC). Methods:The study examined the AIM2 expression in 122 pre-treatment biopsies of LARC by immohistochemistry(IHC). The associations between AIM2 and clinical characters were analyzed. Results:High expression of AIM2 in tumor cells was observed in 26 biopsy specimens. There was no significant correlation between high AIM2 expression in tumor cells and gender(P=0.316),age(P=0.283),differentiation(P=0.356),CEA serum level(P=0.468),tumor location(P=0.309),clinical tumor status(P=0.284),and clinical node status(P=0.264). There were 65(67.7%)specimens with high expression of AIM2 in 96 postoperative specimens(P < 0.001). Univariate and multivariate analysis showed that AIM2 high expression in tumor cells could predict LARC resistance to nCRT:25/26(96.2%)cases with AIM2 high expression tumor showed poor response,while 78/96(81.3%)cases with AIM2 low expression tumor showed good response(P <0.001). After a median follow-up time of 51 months,multivariate analysis showed that high-expression of AIM2 in tumor cells was not correlated with patients’ recurrence free survival(RFS)(P=0.634)or overall survival(OS)(P=0.932). Conclusion:AIM2 expression levels might be a useful indicator of n RCT sensitivity for LARC. The administration of AIM2 signaling pathway antagonist may have the potential to increase rectal cancer radiosensitivity.