C-myc和HIF-1α蛋白在预测巨块型宫颈鳞癌新辅助化疗疗效中的作用

The role of C-myc and HIF-1α protein in the prediction of the response of neoadjuvant intra-arterial chemotherapy in bulky squamous cervical cancer

目的:研究C-myc和低氧诱导因子1α(HIF-1α)蛋白在巨块型宫颈鳞癌新辅助动脉化疗前后的变化以及与化疗疗效的相关性。方法:选取2007年1月-2012年8月在我院因巨块型(Ib2或Ia2期)宫颈鳞癌行新辅助动脉化疗和宫颈癌根治术的患者,共36例,新辅助动脉化疗方案均为顺铂、5-氟尿嘧啶加丝裂霉素的联合化疗。采用Western blot法检测宫颈鳞癌组织中C-myc和HIF-1α蛋白的特异性表达。采用免疫组织化学SP法检测宫颈鳞癌组织中C-myc和HIF-1α蛋白的细胞定位以及两种蛋白在化疗前后、化疗有效组和无效组中的表达差异。结果:1巨块型宫颈鳞癌新辅助动脉化疗的总有效率为52.7%。2C-myc和HIF-1α蛋白在化疗后宫颈鳞癌组织中的表达均显著低于化疗前(均P<0.05)。3化疗前C-myc和HIF-1α蛋白的表达明显相关。4化疗前宫颈鳞癌组织中C-myc和HIF-1α蛋白的表达在化疗有效组中均比化疗无效组中高(均P<0.05)。结论:巨块型宫颈鳞癌组织中C-myc和HIF-1α蛋白的表达可在新辅助动脉化疗前辅助预测化疗疗效。

Objective： To study the change of C-myc and HIF-1α protein expression after neoadjuvant intraarterial chemotherapy and explore the role of C-myc and HIF-1α protein in prediction on the response of neoadjuvant intra-arterial chemotherapy in bulky squamous cervical cancer. Methods： Thirty-six patients with stage Ib2 or IIa2 squamous cervical cancer who underwent neoadjuvant intra-arterial chemotherapy, combined cisplatin with 5-fluorouracil and mitomycin, and radical hysterectomy between 2007 and 2012 in Wenzhou Medical University were selected. Western blot was used to detect the specific expression of C-myc and HIF-1α protein. Then, streptavidin peroxidase（SP） immunohistochemical staining was used to detect the cellular localization of C-myc and HIF-1α protein and the difference of the expression of C-myc and HIF-1α protein between before and after neoadjuvant chemotherapy and between chemotherapy-response group and non-response group. Results： 1The total effective rate of neoadjuvant intra-arterial chemotherapy in bulky squamous cervical cancer was 52.7%. 2The expression of C-myc and HIF-1α protein in tumor cells after chemotherapy was significantly lower than that before chemotherapy（P〈0.05）. 3There was positive correlation between the expression of C-myc protein and HIF-1α protein before chemotherapy. 4The expression of C-myc and HIF-1α protein in chemotherapy-response group before chemotherapy was significantly higher than that in non-response group（P〈0.05）. Conclusion： The expression of C-myc and HIF-1α protein in bulky squamous cervical cancer may be used as a predictor for response to neoadjuvant intra-arterial chemotherapy.