Survivin在食管癌放疗前后的表达及放射敏感性分析

Study on Relationships between Expression of Survivin before and after Radiotherapy and Radiosensitivity of Esophageal Squamous Cell Carcinoma

目的探讨survivin在食管鳞癌术前放疗前后的表达及其与放射敏感性的关系,为食管癌的个体化治疗提供理论依据。方法对2002年1月-2004年6月在河南省肿瘤医院就诊的56例不能直接手术的中晚期食管鳞癌患者采用术前放疗加手术,其中男39例,女17例,年龄42-71岁,术前放疗量DT40Gy/20次/4周,放疗结束后2-3周手术,手术均采用食管部分切除+食管胃颈部吻合术,并用PV600通用型二步法免疫组化检测survivin术前放疗前后的表达水平,分析其在放疗前后表达的差异及其与放疗后病理反应分级及放疗后食道钡餐片分级的关系。结果放疗前活检标本中survivin蛋白表达为0.43±0.24,而放疗后手术标本的sur-vivin蛋白表达0.33±0.27,t=2.735,P=0.08,无统计学意义。放疗前活检标本中survivin蛋白表达与放疗后病理反应及放疗后X线分级均无明显相关性。结论survivin蛋白放疗后表达与放疗前表达无明显差异,可能与肿瘤细胞的加速再增殖有关。Survivin能否作为中晚期食管鳞癌术前放疗的筛选指标及与放射敏感性的关系还需进一步探索。

Objective To study on the relationships between the expression levels of survivin before and after radiotherapy and radiosensitivity, then provid theoretical fundations to individualized treatment of esophageal squamous cell carcinoma. Methods 56 patients with midst and advanced esophageal squamous carcinoma were treated by preoperative radiotherapy with a radiation dose of 40GY/20f/4weeks plus surgery from Juanary 2002 to June 2004. The expression levels of survivin in biopsy samples from all the patients before and after radiotherapy were detected with the PV600 general type two - footwork immunohistochemistry method. The expression levels of survivin before and after radiotherapy, pathologic tumor responses to preoperative radiotherapy, grades of barium meal （BM） movies of esophageal squamous cell carcinoma were analyzed. Results The expression level of survivin in biopsy samples from all the patients before and after radiotherapy were 0. 43 ± 0. 24,0. 33 ± 0. 27, respectively, t = 2. 735, P = 0.08, no statistically significant. The correlation between the expression levels of survivin before radiotherapy and pathologic tumor response to preoperative radiotherapy and BM grades of esophageal squamous cell carcinoma were negative. Conclusion The expression level of survivin before and after radiotherapy were no difference obviously, maybe it is concerned with the accelerated repopulation of tumor cell. It is uncertain whether the expression level of survivin can be considered as a screening index for preoperative radiotherapy. The relationship between the expression levels of survivin before and after radiotherapy and the radiosensitivity of esophageal squamous will be needed to study further.