EGFR蛋白表达水平与结直肠癌放疗敏感性的相关性

Correlation Between EGFR Protein Expression and Radiosensitivity of Colorectal Cancer

为探讨表皮生长因子受体(EGFR)蛋白表达水平与结直肠癌放疗敏感性的相关性。选取我院2014年1月至2014年12月期间肛肠外科收治的50例局部进展期中低位结直肠癌患者,所有患者均接受放疗和直肠全系膜切除并达Ro切除治疗,均保留放疗前后的直肠癌组织病理标本,通过免疫组化SP法检测观察放疗前后病理表本中EGFR蛋白表达变化,根据肿瘤病理消退结果评估放疗敏感性,分析EGFR蛋白表达和放疗敏感性的的关系。50例患者放疗前后病理组织EGFR蛋白表达变化差异无统计学意义(p>0.05),放疗后13例EGFR蛋白表达降低,21例表达无变化,16例表达升高;放疗后肿瘤病理消退42.00%(21/50),58.00%(29/50)患者病理消退并不明显;肿瘤病理消退单因素分析显示放疗方案、放疗总量、放疗前EGFR蛋白表达、放疗后EGFR蛋白表达变化是放疗敏感性的影响因素(x2=8.324,6.721,6.324,5.721,均p<0.05);多因素Logistic回归分析显示放疗方案、放疗前后EGFR蛋白表达变化是放疗敏感性的独立影响因素(OR=2.547,19.824,均p<0.05),放疗后EGFR蛋白表达升高提示结直肠癌患者放疗抵抗。结直肠癌患者放疗后病理组织EGFR蛋白表达变化不一,而放疗前后EGFR蛋白表达水平变化是放疗敏感性的独立影响因素。

In order to investigate the correlation between the expression of epidermal growth factor receptor（EGFR） protein and the radiosensitivity of colorectal cancer,50 cases of patients with locally advanced low and moderate colorectal cancer admitted in the department of anus intestine surgery in our hospital from January 2014 to December 2014 were selected.All patients received radiotherapy and total mesorectal excision and Ro resection,and rectal cancer tissues before and after radiotherapy were retained.The expression of EGFR protein in pathological table before and after radiotherapy was detected by immunohistochemical SP method.The radiosensitivity was evaluated according to the pathological outcome of the tumor,and the relationship between the expression of EGFR protein and radiosensitivity was analyzed.There was no significant difference in the expression of EGFR protein between 50 patients before and after radiotherapy（p〉0.05）.After radiotherapy,the expression of EGFR protein decreased in 13 cases,showed no change in 21 cases,and increased in 16 cases;after radiotherapy,42%（21/50） of patients had tumor regression,while 58%（29/50） of patients did not have obvious pathologic regression.Single factor analysis of tumor pathological regression showed that radiotherapy regimen,total amount of radiation,expression of EGFR protein before radiotherapy and expression of EGFR protein after radiotherapy were the influencing factors of radiosensitivity（x2=8.324,6.721,6.324,5.721;p〈0.05）;Multivariate Logistic regression analysis indicated that the changes of EGFR protein expression were the independent influencing factors of radiotherapy sensitivity before and after radiotherapy（OR=2.547,19.824;p〈0.05）.Elevated levels of EGFR protein after radiotherapy suggested resistance to radiation in colorectal cancer patients.The expression of EGFR protein in pathological tissues of colorectal cancer patients varied after radiotherapy,but the changes of EGFR protein expression before and after radiotherapy were independent influencing factors of radiosensitivity.