进展期胃癌β-tubulinⅢ和survivin的表达及与多西紫杉醇耐药性关系

Relationship Between Expression of β-tubulinⅢ,Survivin and Drug Resistance to Docetaxel in Advanced Gastric Cancer

目的探讨进展期胃癌中β-tubulinⅢ和survivin的表达与多西紫杉醇化疗耐药性关系。方法回顾性分析74例接受多西紫杉醇化疗的晚期胃癌患者的临床病理资料。免疫组织化学法检测肿瘤标本β-tubulinⅢ和survivin蛋白的表达,并对疗效、不良反应进行分析。结果β-tubulinⅢ阳性表达率为37.8%(28/74),survivin阳性表达率为58.1%(43/74),均与性别、年龄及组织类型无关。化疗有效率(CR+PR)为54.10%,β-tubulinⅢ(+)的患者有效率低(32.14%),β-tubulinⅢ(-)患者有效率高(69.57%),差异有显著性(P<0.05)。Survivin(+)组的有效率为32.56%,低于survivin(-)组的67.74%,差异有显著性(P<0.05)。联合检测显示:β-tubulinⅢ(+)且survivin(+)组有效率为25.0%,中位疾病无进展期为4.1个月,1年、2年生存率分别为35.0%、15.0%,β-tubulinⅢ(-)且survivin(-)组有效率为73.91%,中位疾病无进展期为7.8个月,1年、2年生存率分别为56.5%、30.4%,差异均有显著性(P<0.05)。最常见的不良反应为骨髓抑制、消化道反应。结论β-tubulinⅢ和survivin高表达的进展期胃癌患者对多西紫杉醇化疗耐药。

To investigate the relationship between the expression of β -tubulin Ⅲ , survivin protein and ehemoresistanee to docetaxel in advanced gastric cancer. Methods Seventy - four patients of advanced gastric cancer treated with docctaxel were enrolled in this study and their tumor samples were collected retrospectively for analysis. The expression of β - tubulin Ⅲ, survivin protein in tumor samples was detected by the immunohistochemical methods. The data of therapeutical effect and toxicity were collected and analyzed. Re- suits The β - tubulin Ⅲ positive staining accounted for 37.8% （28/74）. The survivin positive staining accounted for 58.1% （ 43/74）. There was no correlation between β -tubulin Ⅲ, survivin positive expression and age, gender, pathological type. The response rate （CR ＋ PR） was 54. 10%. Patients with over - expression of β - tubulin Ⅲ had less response rate （32.14% vs 69.57% ） to docetaxel （P 〈 0.05 ）. Patients with over - expression of survivin had less respeme rate（32.56% vs 67.74% ） to doeetaxel （ P 〈 0.05 ）. Patients with o- ver - expression of β - tubulin Ⅲ and survivin had also lower response rate（25.0% vs 73.91% ,P 〈 0.05 ）. Patients with over - expres- sion of β -tubulin Ⅲ and survivin had also lower the median time to progress and 1 -and 2 -year survival rates（4, lm vs 7.8 m,35.0%vs 56.5% , 15.0% vs 30.4% , P 〈 0.05 ）. The mainside -effects were myelosuppression and digestive apparatus toxicity. Conclusion Over - expression of β - tubulin Ⅲ, survivin in tumor cells was associated with resistance to doeetaxel in patients with advanced gastric cancer receiving docetaxel - based chemotherapy.