晚期大肠癌金属硫蛋白的表达及其与奥沙利铂化疗耐药的关系

Metallothionein over-expression on the impact of Oxaliplatin chemoresistance in advanced colorectal cancer

目的探讨晚期大肠癌金属硫蛋白(Metallothionein,MT)的表达与奥沙利铂耐药及生存时间的关系,以指导化疗方案的选择。方法利用SP免疫组化技术检测180例晚期大肠癌组织中MT的表达情况,表达阳性组及阴性组均予奥沙利铂+亚叶酸钙+5-氟尿嘧啶方案化疗,比较两组的疗效差异,并进行生存分析及多因素回归分析其对预后的影响。结果 MT阴性组的化疗有效率明显优于阳性组(χ2=22.07,P<0.01);MT表达阴性组中位生存期明显长于阳性组(χ2=10.74,P<0.01);多因素回归分析提示MT阳性是晚期大肠癌预后的危险因素。结论 MT与晚期大肠癌对奥沙利铂的耐药存在一定的关联,MT阴性患者对奥沙利铂有较好敏感性,疗效较好。

Objective To study metallothionein （MT） over-expression in advanced colorectal cancer and MT over-expression on the impact of Oxaliplatin chemotherapy. Methods SP immunohistochemical method was used to examine the expression rate of MT in 180 cases with advanced colorectal cancer. 180 patients were divided into 2 groups according to the expres- sion of MT： MT expression positive group and MT expression negative group. All patients in both groups received chemotherapy with Oxaliplatin combined with 5-Fluorouracil and Folinic Acid. Compared to the efficacy of the difference in the two groups,and survival analysis and multivariate prognostic factors of advanced colorectal cancer. Results MT nega- tive group was significantly better than the positive group in short-term effect （χ2=22.07, P 〈 0.01 ） and the median survival time （χ2=10.74, P 〈 0.01 ）; Multiple regression analysis showed that MT expression positive is a risk factor for prognosis in advanced colorectal cancer. Conclusion There is a very close correlation between MT over-expression and Oxaliplatin resis- tance in advanced colorectal cancer. The MT-negative patients with oxaliplatin have a better sensitivity and better efficacy.