外周血与肿瘤组织膜联蛋白A3表达对卵巢上皮癌铂类耐药的预测价值

Predictive value of Annexin A3 protein expression in peripheral blood and tumor tissue for platinum resistance in ovarian epithelial cancer

目的比较外周血与肿瘤组织膜联蛋白A3(Annexin A3)表达对卵巢上皮癌铂类耐药的预测价值。方法选择2010年2月至2012年2月该院术后行以铂类为基础化疗,且完成随访的72例初治卵巢上皮癌患者,按照铂类耐药评价标准分为铂类化疗敏感组54例和铂类化疗耐药组18例,采用化学发光免疫分析法检测外周血Annexin A3水平;采用免疫组织化学染色检测肿瘤组织Annexin A3水平;通过绘制受试者工作特征(ROC)曲线分析外周血与肿瘤组织Annexin A3对铂类耐药的预测价值。结果铂类敏感组外周血Annexin A3水平显著低于铂类耐药组,差异有统计学意义(P<0.05),铂类敏感组肿瘤组织Annexin A3表达阳性率显著低于铂类耐药组(P<0.05)。外周血Annexin A3低浓度组中位生存期(31.2个月)显著高于高浓度组(23.1个月),差异有统计学意义(P<0.05);组织Annexin A3低表达组中位生存期(35.2个月)显著高于高表达组(20.4个月),差异有统计学意义(P<0.05)。多因素分析显示,血清与肿瘤组织Annexin A3表达水平是影响铂类耐药的独立危险因素(均P<0.05)。外周血Annexin A3预测铂类耐药的ROC曲线下面积(AUC)为0.821;组织Annexin A3预测铂类耐药的AUC为0.763;外周血Annexin A3预测铂类耐药的AUC显著高于组织Annexin A3。结论铂类耐药的卵巢上皮癌患者外周血与肿瘤组织Annexin A3表达水平均显著升高,外周血Annexin A3对铂类耐药的预测价值优于组织Annexin A3。

Objective To compare the values of peripheral blood and tumor tissue Annexin A3 protein expressions for predictinge platinum resistance in ovarian epithelial cancer.Methods A total of 72 cases of newly treated ovarian epithelial cancer and undergoing platinum based chemotherapy after surgery,and completely followed up in this hospital from February 2010 to February2012 were selected and divided into the platinum-sensitive group（54 cases）and platinum-resistant group（18 cases）according to the platinum resistance evaluation criteria.Peripheral blood Annexin A3 level was detected by chemiluminescence immunoassay.Tumor tissue Annexin A3 level was detected by adopting the immunohistochemical staining.The predictive value of peripheral blood and tumor tissue Annexin A3 for predicting platinum resistance was analyzed by drawing the ROC curve.Results The peripheral blood Annexin A3 level in the platinum-sensitive group was significantly lower than that in the platinum-resistant group,the difference was statistically significant（P〈0.05）,the positive rate of tumor tissue Annexin A3 expression in the platinum sensitivity group was significantly lower than that of platinum-resistant group（P〈0.05）.The median survival time in peripheral blood Annexin A3 low concentration group was significantly higher than that of high concentration group（31.2 months vs.20.4 months,P〈0.05）.The median survival time in tissue Annexin A3 low expression group was significantly higher than that in the high expression group（35.2 months vs.23.1 months P〈0.05）.The multivariate analysis showed that the level of Annexin A3 expression in serum and tumor tissue were the independent risk factor for affecting platinum resistance（all P〈0.05）.The area of curve（AUC）of peripheral blood Annexin A3 in predicting platinum resistance was 0.821,which of tissue Annexin A3 in predicting platinum was 0.763,peripheral blood Annexin A3 for predicting platinum resistance was significantly higher than tissue Annexin A3（P〈0.05）.Conclusion The expression levels of Annexin A3 protein in peripheral blood and tumor tissue are significantly increased in the patients with platinum resistant ovarian cancer,the predictive value of Annexin A3 protein in peripheral blood for platinum resistance is better than that of tissue Annexin A3 protein.