新辅助化疗对胃癌组织COX-2和Survivin蛋白表达的影响

Effects of neo-adjuvant chemotherapy of gastric carcinoma on the expression of Survivin and COX-2

目的:探讨胃癌组织COX-2和Survivin蛋白的表达在预测胃癌新辅助化疗敏感性中的作用。方法:选择胃癌患者96例,分为实验组(42例)和对照组(54例)。实验组应用FOLFOX4方案行新辅助化疗,3周后手术,评估疗效并据此区分敏感组和不敏感组。对照组常规手术。术前术后留取胃癌组织标本,应用免疫组织化学SP法检测胃癌组织中COX-2和Survivin蛋白的表达。结果:实验组胃癌组织中COX-2蛋白的表达在处理前后的差值较对照组显著下降(t=3.452,P=0.002),而Survivin蛋白表达显著上升(t=3.751,P=0.017)。处理前后Survivin蛋白表达的变化在敏感组和不敏感组之间差异显著(t=2.673,P<0.05),Survivin在敏感组化疗前呈相对低表达。结论:Survivin蛋白低表达者对新辅助化疗相对敏感,Survivin有望成为预测胃癌新辅助化疗的敏感性指标。

Aim： To investigate the predictability of cyclooxygenase-2（COX-2）and Survivin on sensitivity of Neo-adjuvant chemotherapy in gastric carcinoma.Methods：96 gastric carcinoma patients were divided into the experimental group with 42 cases treated by both Neo-adjuvant chemotherapy of FOLFOX 4 and surgery and 54 cases with routine surgery as control.Surgery would be performed three weeks after the chemotherapy on the experimental group.Define the sensitive and insensitive cases by the comparative efficacy before and after surgery.Record the expression of COX-2 and Survivin protein in gastric carcinoma tissues before and after surgery by SP.Results：The differences of COX-2 expressions before and after treatment showed obvious differences（t=3.452,P=0.002）,while an ascending tendency of the Survivin expressions（t=3.751,P=0.017）between the experimental and control group.Survivin expressions shown significant difference between sensitive and insensitive group before and after Neo-adjuvant chemotherapy（t=2.673,P=0.027）.It shown low-level expression of Survivin and significant difference in pre-Neoadjuvant chemotherapy of sensitive group.Conclusion： Patients with low-level Survivin expression was more sensitive to Neo-adjuvant chemotherapy.The expression of Survivin could be a sensitive indicator in predicting the efficacy of Neo-adjuvant chemotherapy in gastric carcinoma.