Ki67和Bax在局部晚期宫颈癌新辅助化疗前后表达的意义

The significance of Ki67 and Bax expressions before and after neoadjuvant chemotherapy in locally advanced cervical carcinoma.

目的:探讨K i67、Bax与宫颈癌新辅助化疗疗效和预后之间的关系。方法:在新辅助化疗(neoad juvant chemotherapy,NACT)前后用免疫组化方法检测23例局部晚期宫颈癌组织K i67和Bax的表达。结果:临床总有效率为82.61%。化疗有反应者NACT前后K i67、Bax表达有统计学差异(P<0.05);无反应者NACT前后K i67、Bax表达无统计学差异(P>0.05)。不同病理类型和临床分期患者NACT前后K i67和Bax变化值无显著性差异;不同病理分级患者NACT前后Bax变化值有统计学差异(P<0.05)。NACT前K i67 LI>33%和K i67 LI<33%患者的平均无瘤生存期分别为48.6个月和19个月(P<0.05)。结论:K i67、Bax与化疗疗效显著相关。K i67、Bax有可能作为判断化疗疗效和预后的指标。

Objective：To study the correlation of the expression of Ki67, Bax protein before and after neoadjuvant chemotherapy with clinical effect and prognosis. Methods：The expression of Ki67 and Bax protein were evaluated in tumor samples by immunohistochemistry before and after NACT in 23 patients with locally advanced cervical cancer. Results：Overall clinical response was 82.61%. The expression of Ki67 and Bax protein did not differ between responders and non-responders before chemotherapy. After chemotherapy, the expression of Bax was significantly higher for responders than that for non-responders;while the expression of Ki67 was significantly lower for responders than that for non-responders （ P 〈 0.05 ）. Bax discrepancy before and after NACT was associated with grade of differentiation, but not with the others;Ki67 discrepancy before and after NACT was not associated with clinical pathological factors. The mean disease-free survival of patients with Ki67 LI 〉 33 % before chemotherapy was signifantly longer than that of patients with Ki67 LI 〈33% （48.6 months vs 19 months,P 〈 0. 05 ）. Conclusions： Ki67 and Bax protein expressions were associated with clinical effect of neoadjuvant intraarterial chemotherapy, which may be reference marker of clinical effect and prognosis.