胃癌组织中BRCA1蛋白表达、血清TAP水平变化与铂类化疗效果的关系分析

Relationship between expression of BRCA1 protein, serum TAP and the efficacy of platinum-based chemotherapy in patients with gastric cancer

目的探讨胃癌组织中乳腺癌易感基因1(BRCA1)蛋白、血清肿瘤异常蛋白(TAP)的水平与胃癌患者铂类化疗方案疗效的关系。方法对108例晚期胃癌术后患者进行奥沙利铂+替吉奥化疗。采用免疫组化法检测患者肿瘤组织中的BRCA1蛋白表达及血清TAP水平变化,分析其与化疗疗效及预后的关系。结果 108例胃癌患者中BRCA1蛋白阳性表达29例,阴性表达79例。与化疗前比较,化疗后血清TAP水平升高30例,水平降低78例。BRCA1蛋白阳性表达患者的缓解率低于阴性表达患者(P﹤0.05);化疗后血清TAP水平升高患者的缓解率明显低于TAP水平下降患者(P﹤0.01)。BRCA1蛋白阳性表达患者的1年累积生存率低于阴性表达患者,中位生存时间短于阴性表达的患者,差异均有统计学意义(P﹤0.05)。化疗后血清TAP水平升高的患者1年累积生存率明显低于TAP水平降低患者(P﹤0.01),中位生存时间短于TAP水平降低的患者(P﹤0.05)。结论晚期胃癌患者的BACR1蛋白阳性表达情况及血清TAP水平与患者的疗效及预后有关。

Objective To investigate the relationship between the level of breast cancer susceptibility gene 1 (BRCA1) protein and serum tumor abnormal protein (TAP) and the efficacy of platinum-based chemotherapy in gastric cancer patients. Method 108 patients with advanced gastric cancer after operation were treated with oxaliplatin+tegafur/ gimeracil/oteracil (S-1) chemotherapy. The expression of BRCA1 protein and the level of TAP in serum were detected by immunohistochemistry, and the relationship between BRCA1 protein and the efficacy and prognosis of chemotherapy was analyzed. Result Among 108 patients with gastric cancer, 29 were positive for BRCA1 protein and 79 were negative for expression. Compared with before chemotherapy, serum TAP levels increased after chemotherapy in 30 cases, and the level decreased in 78 cases. The response rate of patients with positive BRCA1 protein expression was lower than that of patients with negative expression (P<0.05). The response rate in gastric cancer patients with elevated serum TAP level after chemotherapy was significantly lower than that of patients with decreased TAP (P<0.01). The one-year cumulative survival rate of patients with positive BRCA1 expression was lower than of patients with negative expression, and the median survival time was shorter than that of negative expression (P<0.05). The one- year cumulative survival rate of patients with elevated serum TAP levels after chemotherapy was significantly lower than that of patients with decreased TAP (P< 0.01), and the median survival time was shorter than that of patients with decreased TAP (P<0.05). Conclusion The positive expression of BACR1 protein and serum TAP level are closely related to the efficacy of chemotherapy and prognosis of patients.