BJC：一种肿瘤退化实时监控新方法
2010-06-06 抗癌健康网
专注健康 关爱生命 英国诺丁汉大学一研究小组在最近一期的《英国癌症研究期刊》上发表论文称，使用免疫组织化学染色法来对肿瘤退化及ERCC1核蛋白表达进行评估，是对接受辅助性化疗手段的贲门癌患者进行病情实时监测的有效办法。该发现或对未来贲门癌的临床治疗产生重大影响，从而给患者带来新的希望。
贲门癌是一种特殊类型的胃癌，肿瘤产生于食管与胃部的连接部位，也称胃—食管连接部癌。该种癌症与其他部位的胃癌不同，具有自己的组织学特性和临床表现，其诊断和治疗方法较为独特，外科治疗效果也比较差，目前还没有患者能在诊断出该种疾病后活过5年。现在较为流行的标准治疗方案是先对患者进行12周的高强度化疗，然后进行外科手术，之后再做为期12周的化疗。实践表明，该治疗方案的效果并不明显，长时间的化疗不仅对病人的身体有极大影响，且只对那些对化疗有反应的病人有作用。
英国诺丁汉大学及该校附属医院的专家组成的贲门癌研究小组，在过去5年一直致力于该种疾病的研究，希望能找到改进该疾病治疗方法的手段。他们在研究论文中指出，通过免疫组织化学染色法，可以对贲门癌患者的肿瘤退化及ERCC1核蛋白表达情况进行实时监控，使医生能够在治疗期间对肿瘤的发展情况进行评估，从而帮助其决断是否采用后续的化疗手段。他们进行的实验验证了该种方法的有效性，对大约250名患者手术后的肿瘤样本进行的分析显示，术后化疗只对40%至50%的患者起作用。
研究人员认为，新发现可使医生能够判定在手术后进行第二次化疗的必要性，从而为贲门癌患者提供更合适的治疗手段，同时也为进行更广泛、专业的临床研究铺平了道路，将对未来该种癌症的临床治疗产生重大影响。
随着人们饮食习惯和生活方式的改变，贲门癌的发病率呈逐渐增长之势。英国人的贲门癌发病率是世界上所有白人里最高的。据英国癌症研究中心统计，自20世纪70年代以来,该种癌症在英国男性中的发病率增加了50%，在女性中增加了20%。而在我国，贲门癌的发病率和死亡率在各类恶性肿瘤中也位居前列。
生物谷推荐原文出处：
British Journal of Cancer doi:10.1038/sj.bjc.6605686
Tumour regression and ERCC1 nuclear protein expression predict clinical outcome in patients with gastro-oesophageal cancer treated with neoadjuvant chemotherapy
K R Fareed, A Al-Attar, I N Soomro, P V Kaye, J Patel, D N Lobo, S L Parsons and S Madhusudan
Aims:
Neoadjuvant chemotherapy followed by surgery is the standard of care for patients with gastro-oesophageal adenocarcinoma. Previously, we validated the utility of the tumour regression grade (TRG) as a histopathological marker of tumour downstaging in patients receiving platinum-based neoadjuvant chemotherapy. In this study we profiled key DNA repair and damage signalling factors and correlated them with clinicopathological outcomes, including TRG response.
Methods and results:
Formalin-fixed human gastro-oesophageal cancers were constructed into tissue microarrays (TMAs). The first set consisted of 142 gastric/gastro-oesophageal cancer cases not exposed to neoadjuvant chemotherapy and the second set consisted of 103 gastric/gastro-oesophageal cancer cases exposed to preoperative platinum-based chemotherapy. Expressions of ERCC1, XPF, FANCD2, APE1 and p53 were investigated using immunohistochemistry.
In patients who received neoadjuvant chemotherapy, favourable TRG response (TRG 1, 2 or 3) was associated with improvement in disease-specific survival (P=0.038). ERCC1 nuclear expression correlated with lack of histopathological response (TRG 4 or 5) to neoadjuvant chemotherapy (P=0.006) and was associated with poor disease-specific (P=0.020) and overall survival (P=0.040).
Conclusions:
We provide evidence that tumour regression and ERCC1 nuclear protein expression evaluated by immunohistochemistry are promising predictive markers in gastro-oesophageal cancer patients receiving neoadjuvant platinum-based chemotherapy.
贲门癌是一种特殊类型的胃癌，肿瘤产生于食管与胃部的连接部位，也称胃—食管连接部癌。该种癌症与其他部位的胃癌不同，具有自己的组织学特性和临床表现，其诊断和治疗方法较为独特，外科治疗效果也比较差，目前还没有患者能在诊断出该种疾病后活过5年。现在较为流行的标准治疗方案是先对患者进行12周的高强度化疗，然后进行外科手术，之后再做为期12周的化疗。实践表明，该治疗方案的效果并不明显，长时间的化疗不仅对病人的身体有极大影响，且只对那些对化疗有反应的病人有作用。
英国诺丁汉大学及该校附属医院的专家组成的贲门癌研究小组，在过去5年一直致力于该种疾病的研究，希望能找到改进该疾病治疗方法的手段。他们在研究论文中指出，通过免疫组织化学染色法，可以对贲门癌患者的肿瘤退化及ERCC1核蛋白表达情况进行实时监控，使医生能够在治疗期间对肿瘤的发展情况进行评估，从而帮助其决断是否采用后续的化疗手段。他们进行的实验验证了该种方法的有效性，对大约250名患者手术后的肿瘤样本进行的分析显示，术后化疗只对40%至50%的患者起作用。
研究人员认为，新发现可使医生能够判定在手术后进行第二次化疗的必要性，从而为贲门癌患者提供更合适的治疗手段，同时也为进行更广泛、专业的临床研究铺平了道路，将对未来该种癌症的临床治疗产生重大影响。
随着人们饮食习惯和生活方式的改变，贲门癌的发病率呈逐渐增长之势。英国人的贲门癌发病率是世界上所有白人里最高的。据英国癌症研究中心统计，自20世纪70年代以来,该种癌症在英国男性中的发病率增加了50%，在女性中增加了20%。而在我国，贲门癌的发病率和死亡率在各类恶性肿瘤中也位居前列。
生物谷推荐原文出处：
British Journal of Cancer doi:10.1038/sj.bjc.6605686
Tumour regression and ERCC1 nuclear protein expression predict clinical outcome in patients with gastro-oesophageal cancer treated with neoadjuvant chemotherapy
K R Fareed, A Al-Attar, I N Soomro, P V Kaye, J Patel, D N Lobo, S L Parsons and S Madhusudan
Aims:
Neoadjuvant chemotherapy followed by surgery is the standard of care for patients with gastro-oesophageal adenocarcinoma. Previously, we validated the utility of the tumour regression grade (TRG) as a histopathological marker of tumour downstaging in patients receiving platinum-based neoadjuvant chemotherapy. In this study we profiled key DNA repair and damage signalling factors and correlated them with clinicopathological outcomes, including TRG response.
Methods and results:
Formalin-fixed human gastro-oesophageal cancers were constructed into tissue microarrays (TMAs). The first set consisted of 142 gastric/gastro-oesophageal cancer cases not exposed to neoadjuvant chemotherapy and the second set consisted of 103 gastric/gastro-oesophageal cancer cases exposed to preoperative platinum-based chemotherapy. Expressions of ERCC1, XPF, FANCD2, APE1 and p53 were investigated using immunohistochemistry.
In patients who received neoadjuvant chemotherapy, favourable TRG response (TRG 1, 2 or 3) was associated with improvement in disease-specific survival (P=0.038). ERCC1 nuclear expression correlated with lack of histopathological response (TRG 4 or 5) to neoadjuvant chemotherapy (P=0.006) and was associated with poor disease-specific (P=0.020) and overall survival (P=0.040).
Conclusions:
We provide evidence that tumour regression and ERCC1 nuclear protein expression evaluated by immunohistochemistry are promising predictive markers in gastro-oesophageal cancer patients receiving neoadjuvant platinum-based chemotherapy.
