survivin和caspase-3在食管鳞癌术前放疗前后的表达与放射敏感性关系分析

Study on relationships between the expression levels of survivin and caspase-3 before and after preoperative radiotherapy and radiosensitivity of esophageal squamous cell carcinoma

目的探讨survivin和caspase-3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56例中晚期食管鳞癌患者采用术前放疗加手术,用PV600通用型二步法免疫组化检测survivin和caspase-3于术前放疗前后的表达水平,分析二者放疗前后表达的差异及其与放疗后病理反应分级的关系。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survivin蛋白表达0.33±0.27,t=2.735,P=0.08,差异无显著性;放疗前活检标本中caspase-3蛋白表达为0.33±0.18,而放疗后手术标本的caspase-3蛋白表达0.43±0.27,t=-2.986,P=0.04,差异有显著性。放疗后caspase-3蛋白表达与放疗后survivin蛋白表达呈负相关(P=0.00);放疗前caspase-3蛋白表达与放疗前后survivin蛋白表达均无明显相关关系。放疗前后survivin蛋白表达与放疗后病理反应均无明显相关性;放疗前caspase-3蛋白表达与放疗后病理反应呈正相关(P=0.005),而放疗后caspase-3蛋白表达与放疗后病理反应无明显相关性。结论caspase-3蛋白表达越高,肿瘤细胞的放射敏感性越强。caspase-3表达可作为中晚期食管鳞癌术前放疗的筛选指标之一,具有相对较好的评价意义。Survivin与放射敏感性的关系还需进一步探索。

Objective To study the relationship between the expression levels of survivin and caspase-3 before and after preoperative radiotherapy and radiosensitivity,in order to provide theoretical basis for individualized treatment of esophageal squamous cell carcinoma. Methods Fifty-six patients with middie-stage and advanced esophageal squamous cell carcinoma were treated with preoperative radiotherapy plus surgry. The expression levels of survivin and caspase-3 in biopsy samples from all patients before and after radiotherapy were detected with the PV600 general type two-step immunohistochemistry method. The expression levels of survivin and caspase-3 before and after radiotherapy and tumor pathology response to preoperative radiotherapy were analyzed. Results The expression level of survivin in biopsy samples from all patients before and after radiotherapy were 0. 43± 0. 24 and 0. 33 ± 0. 27, respectively, t = 2. 735, P = 0. 08, with no statistical significance. The expression level of caspase-3 in biopsy samples from all patients before and after radiotherapy were 0. 33±0. 18 and 0. 43±0. 27,respectively, t = -2. 986,P =0. 04. The expression level of caspase-3 after radiotherapy was negatively correlated with the expression level of survivin after radiotherapy （P = 0. 00）. However, the expression level of caspase-3 in biopsy samples before radiotherapy was not correlated to the expression level of survivin before and after radiotherapy. The expression levels of survivin before and after radiotherapy were tumor pathologic response after radiotherapy. However the expression level of caspase-3 in biopsy samples before radiotherapy was positively correlated to tumor pathologic response, P = 0. 005. The expression level of caspase-3 in biopsy samples after radiotherapy was not correlated to tumor pathologic response. Conclusion The higher the expression level of caspase-3,the stronger the radiosensitivity of esophageal squamous cell carcinoma. The expression level of caspase-3 before radiotherapy can be considered as a screening index for preoperative radiotherapy. The relationship between the expression levels of survivin and the radiosensitivity of esophageal squamous cell carcinoma needs to be studied further.