TopoⅡ、Ki-67、P53在胃食管结合部腺癌新辅助化疗疗效预测中的意义

The prediction of Topo Ⅱ, Ki67,P53 binding of neoadjuvant chemotherapy in adenocarcinoma of gastroesophageal junction

目的探讨TopoⅡ、Ki-67和P53在SiewertⅡ型胃食管结合部腺癌中的表达与化疗敏感性之间的关系。方法回顾性分析本院2010年6月~2013年12月行新辅助化疗的胃食管结合部腺癌患者72例。对所有患者均行SOX方案化疗,以RECIST 1.0评价标准评价疗效。用免疫组化方法评价3种蛋白的表达情况,分析各蛋白表达情况及与化疗疗效的关系。结果年龄和病理类型与化疗敏感性无关,本组72例患者中新辅助化疗有效率为48.6%,其中5例达病理完全缓解。3种蛋白的表达情况分别为：TopoⅡ阳性率为73.6%,Ki-67阳性率为59.7%,P53阳性率为33.3%。Ki-67和P53的表达与化疗敏感性有关（P=0.023,P=0.031）,但TopoⅡ的表达与化疗敏感性无关（P〉0.05）。结论 Ki-67高表达和P53低表达是AGEJ SOX方案新辅助化疗敏感性的影响因素,为AGEJ个体化新辅助化疗方案的选择提供有益的参考。

Objective To investigate the expression of Topo Ⅱ, Ki-67, P53 in advanced adenocarcinoma of gastroesophageal junction（AGEJ） and its relationship to sensitivity of neoadjuvant chemotherapy. Methods Clinical data of 72 patients of locally advanced AGEJ between June 2010 and Dec 2013 were analyzed retrospectively. All patients were given SOX neoadjuvant chemotherapy and the responses to treatment were evaluated according to RECIST 1.0. Expressions of 3 proteins were detected by in all patients before neoadjuvant chemotherapy. Detecting the expressions of Topo Ⅱ, Ki-67, P53 by immunohistochemistry is to analyze its relationship to neoadjuvant chemotherapy. Results The chemotherapy sensitivity had no correlation with age and pathological types（P〉0.05）. The overall response rates was 48.6%, including complete response in 5 cases and progressive disease in 6 cases.The positive expression rates of Topo Ⅱ, Ki-67 and P53 in AGEJ were 73.6%,59.7% and 33.3%. Ki-67 and P53 were significantly correlated with chemotherapy sensitivity（P=0.003,P=0.020）, while Topo Ⅱ was not correlated with chemotherapy sensitivity（P〉0.05）.Conclusion An elevated expression of Ki-67 and depressed expression of P53 are important factors for SOX insensitivity in AGEJ. They may provide an useful reference for designing individualized chemotherapeutic regimens for AGEJ patients.