凋亡抑制蛋白XIAP和Survivin在晚期胃癌中的表达及其与含多西紫杉醇方案化疗疗效的相关性

Correlation between the XIAP and Survivin protein expression and the efficacy of chemotherapy containing docetaxel regimen in advanced gastric cancer

目的:探讨凋亡抑制蛋白XIAP和Survivin在晚期胃癌组织中的表达及与含多西紫杉醇方案化疗疗效的相关性。方法:回顾性分析68例接受含多西紫杉醇方案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XIAP和Survivin蛋白的表达,并对其疗效、不良反应进行分析。结果:XIAP高表达率为41.18%(28/68),Survivin高表达率为38.24%(26/68),化疗的疾病控制率(CR+PR+SD)为72.06%,XIAP高表达的患者有效率低(50.00%),XIAP低表达的患者有效率高(8 7.5 0%),差异有显著性(P<0.01)。Survivin高表达组的有效率为57.69%,低于Survivin低表达组的80.95%,差异有显著性(P=0.038)。联合检测显示:XIAP和Survivin同时高表达者有效率为25.0%,而XIAP且Survivin均为低表达组有效率为88.46%(P<0.01)。生存分析结果显示Survivin低表达者及XIAP低表达者PFS均优于高表达者(P值分别等于0.058和<0.01);两者同时高表达患者PFS最差,中位PFS仅2个月,明显差于两者均低表达者(P<0.01)。化疗最常见的不良反应为骨髓抑制及消化道反应,且与XIAP及Survivin表达无相关性。结论:XIAP和Survivin高表达的晚期胃癌患者对含多西紫杉醇方案化疗疗效较差,其疾病无进展期也短于XIAP和Survivin低表达者。

Objective：To investigate the relationship between the expression of XIAP,Survivin protein and the efficacy of chemotherapy containing docetaxel regimen in advanced gastric cancer.Methods：Retrospectively analyze 68 patients with advanced gastric cancer receiving docetaxel chemotherapy and their clinical and pathological material.XIAP and Survivin protein expression in the tumor tissues were evaluated using immunohistochemistry and their effects on the efficiency and adverse effect of chemotherapy were analysed.Results：Proportion of XIAP high expression was 41.18%（28 /68） and Survivin was 38.24%（26 /68）.The overall response rate（ CR ＋ PR ＋ SD） of chemotherapy was 72.06%,which was lower in the patients with XIAP high expression than that with low expression（50.00% vs 87.50%,P〈0.01）.The response rate in Survivin high expression group was also lower than low expression group（ 57.69% vs 80.95%,P = 0.038）.Combined detection of XIAP and Survivin indicated lower response rate in both high group than in both low group（25.0% vs 88.46%,P〈0.01）.Survival analysis indicated that the patients with advanced gastric cancer had poor PFS in XIAP or Survivin high expression group than in low expression group（ P〈0.01 and P = 0.058）.The PFS was only 2 months in the patients with XIAP and Survivin both high expression,much poor than that both low expression（ P〈0.01）.The main side-effects were myelosuppression and digestive apparatus toxicity,but not related to the expression states XIAP or Survivin.Conclusion：High expression of XIAP and Survivin in patients with advanced gastric cancer were shown poorer efficacy to chemotherapy with docetaxel scheme,and the disease progression-free period is shorter than lower XIAP and Survivin expression.