以铂类为基础的新辅助化疗疗效与胃癌临床病理特征及泛素特异性蛋白酶39的相关性研究

Correlation Analysis of the Efficacy of Neoadjuvant Chemotherapy Based on Platinum and the Clinicopathologic Features of Gastric Carcinoma and USP39

背景胃癌新辅助化疗是胃癌综合治疗的重要内容,取得了很好的结果,但是仍然有部分患者在治疗期间疾病进展,失去治疗机会。寻找能够预测新辅助化疗疗效的指标是今后研究的热点。目的探讨以铂类为基础的新辅助化疗疗效与胃癌临床病理特征及泛素特异性蛋白酶39(USP39)的相关性。方法选取2012—2013年在中国人民解放军总医院进行以铂类为基础的新辅助化疗的胃癌患者44例为研究对象,采用以铂类为基础的新辅助化疗SOX方案进行治疗,根据治疗效果分为有效组和无效组。收集患者的临床病理资料,采用免疫组织化学及Western blotting法检测USP39的表达。结果 44例患者采用以铂类为基础的新辅助化疗SOX方案,其中有效组23例,无效组21例。有效组与无效组患者性别、年龄、病程、血红蛋白、中性粒细胞分数(N)、淋巴细胞分数(L)、血清清蛋白水平及肿瘤部位、肿瘤大小、分化程度、术前化疗疗程比较,差异均无统计学意义(P>0.05)。无效组患者N/L≥3及USP39阳性率高于有效组(P<0.05)。结论以铂类为基础的新辅助化疗治疗胃癌,有效组患者的N/L、USP39低于无效组,N/L、USP39有可能成为预测胃癌以铂类为基础的新辅助化疗疗效的有效分子。

Background Neoadjuvant chemotherapy is a crucial part of the comprehensive treatment of gastric carcinoma, and it has favorable efficacy. However, there are also some patients who undergo disease progression during the therapy and lose the opportunity for treatment. Finding the indexes that predict the efficacy of neoadjuvant chemotherapy is a hot topic in the future research. Objective To explore the correlation between the efficacy of neoadjuvant chemotherapy based on platinum and clinicopathologic features as well as the expression of USP39. Methods A total of 44 patients with gastric cancer who were administrated with neoadjuvant chemotherapy based on platinum in Chinese PLA General Hospital from 2012 to 2013, and neoadjuvant chemotherapy of SOX scheme based on platinum was employed. The patients were divided into effective group and ineffective group according to therapeutic effects. The clinical clinicopathological data, paraffin embedded tissues and fresh frozen cancerous tissues were collected, and USP39 was detected using immunohistochemistry and Western blotting. Results Neoadjuvant chemotherapy of SOX scheme based on platinum was undertaken on the 44 patients, among which 23 were of effective group and 21 were of ineffective group. The two groups were not significantly different in gender, age, course of disease hemoglobin, neutrophils score （ N ）, lymphocyte score （ L ） , serum albumin level, tumor site, tumor size, differentiated degree and preoperative chemotherapy treatment course （ P 〉 0, 05 ） . The ineffective group was higher than effective group in the number of patients with N/L ≥ 3 and the positive rate of USP39 （P 〈 0. 05） .Condusion After neoadjuvant chemotherapy based on platinum, the effective group is higher than ineffective group in the levels of N/L and USP39. N/L and USP39 may become effective predictors for the efficacy of neoadjuvant chemotherapy based on platinum.