RPL23、MDM2表达与胃癌术后辅助化疗疗效及毒副反应的相关性研究

Correlation research on the expression of RPL23,MDM2 with the curative effect of postoperative adjuvant chemotherapy and adverse reactions in patients with gastric cancer

目的研究胃癌组织中核糖体蛋白L23(RPL23)、鼠双微体2(MDM2)蛋白表达与术后辅助化疗效果及毒副反应之间的关系,对胃癌化疗获益人群进行探索性分析。方法回顾性收集胃癌根治术并行术后辅助化疗患者34例,免疫组化检测胃癌组织中RPL23、MDM2表达,统计学分析其与3年无病生存期(DFS)及化疗毒副反应之间的关系。结果 34例患者中,RPL23、MDM2阳性表达率分别为23.5%、58.8%。RPL23(χ2=9.946,P=0.002)、MDM2(χ~2=12.560,P<0.001)是影响患者3年DFS获益的重要因素,RPL23阳性患者中位DFS为17.4个月,明显低于阴性患者(26.7个月)(χ~2=10.90,P=0.001);MDM2阳性患者DFS为28.2个月,明显高于阴性表达患者(18.4个月)(χ~2=20.42,P<0.001)。血液毒副反应方面,RPL23阳性患者的发生率为50.0%,明显高于阴性表达患者(11.5%)(P=0.037);MDM2阳性表达患者为5.0%,低于阴性表达患者(42.9%)(P=0.012);RPL23、MDM2表达与患者胃肠毒性反应发生率之间差异无统计学意义(P>0.05)。结论 RPL23、MDM2在胃癌组织中表达有可能作为患者术后辅助化疗效果及血液毒副反应的预测指标。

Objective To investigate the correlation of expression of ribosomal protein L23 （RPL23）, mufine double minute 2 （MDM2） in gastric cancer tissue with the curative effect of postoperative adjuvant chemotherapy and adverse reac- tions, so as to make exploratory analysis for the specific group benefited from chemotherapy of gastric cancer. Methods Thirty-four patients with gastric cancer received radical gastrectomy and postoperative adjuvant chemotherapy were col- lected retrospectively. The expression of RPL23 and MDM2 in the gastric cancer tissue was detected by immunohisto- chemistry. The relationship of their expression with 3-year disease-free survival （DFS） and adverse reactions were ana- lyzed statistically. Results Among 34 patients, the positive rate of RPL23, MDM2 was 23.5%, 58.8% respectively. The expression of RPL23 （X2=9.946, P = 0.002） and MDM2 （X2=12.560, P 〈 0.001） were the important factors influencing the benefit from 3-year DFS. The median DFS of patients with positive RPL23 was 17.4 months, which was significant- ly lower than that of negative patients （26.7 months） （X2=10.90, P = 0.001）, the DFS of patients with positive MDM2 was 28.2 months, which was significantly higher than that of negative patients （18.4 months） （X2=20.42, P 〈 0.001）. In the aspects of blood adverse reactions, the incidence of patients with positive RPL23 was 50.0%, which was signifi- cantly higher than that of negative patients （11.5%） （P = 0.037）; the incidence of patients with positive MDM2 was 5.0%, which was significantly lower than that of negative patients （42.9%） （P = 0.012）; there were no significant differ- ences of the expression of RPL23, MDM2 with the incidence of gastrointestinal adverse reactions （P 〉 0.05）. Conclu- sion The expression of RPL23 and MDM2 may be as the predictive indexes for the curative effect of postoperative adjuvant chemotherapy and blood adverse reactions.