摘要
目的:探讨Kruppel样因子6(KLF6)、p21蛋白表达与中晚期(Ⅱb-Ⅲb)宫颈癌同步放化疗敏感性的关系。方法:选取108例Ⅱb-Ⅲb期宫颈癌患者作为受试对象,均行同步放化疗,根据病变好转情况分为放化疗敏感组81例和放化疗不敏感组27例。用免疫组织化学法检测所有受试者组织中KLF6、p21蛋白水平,分析二者表达与Ⅱb-Ⅲb期宫颈癌患者同步放化疗敏感性及3年总生存率(OS)的关系。结果:放化疗敏感组与不敏感组患者的肿瘤分化程度、肿瘤大小差异有统计学意义(P<0.05);两组患者年龄、FIGO分期、淋巴结转移及化疗方案差异均无统计学意义(P>0.05)。KLF6蛋白低表达患者同步放化疗总有效率明显低于高表达患者(P<0.05),p21蛋白低表达患者总有效率显著高于高表达患者(P<0.05)。KLF6、p21蛋白表达与Ⅱb-Ⅲb期宫颈癌患者FIGO分期、肿瘤分化程度、肿瘤大小及放化疗敏感性有关(P<0.05)。KLF6低表达患者OS明显低于高表达患者(P<0.05);p21高表达患者OS显著低于低表达患者(P<0.05)。多因素分析显示KLF6、p21表达是影响患者预后的独立危险因素(P<0.05)。结论:KLF6高表达、p21低表达的Ⅱb-Ⅲb期宫颈癌患者同步放化疗敏感性强,其放化疗总有效率及3年OS均较高,可作为预后判断的依据。
Objective:To investigate the relationships between the expressions of Kruppel-like factor 6(KLF6) and p21 protein with the sensitivity of concurrent chemoradiotherapy in middle and late stage(Ⅱb-Ⅲb) cervical cancer.Methods:108 patients with stage Ⅱb-Ⅲb cervical cancer were selected as subjects.All patients underwent concurrent chemoradiotherapy.According to the improvement of the disease,the patients were divided into 81 cases in chemoradiotherapy sensitive group and 27 cases in chemoradiotherapy insensitive group.The levels of KLF6 and p21 protein in all subjects were detected by immunohistochemistry.The relationships between the expressions of the two with the sensitivity of concurrent chemoradiotherapy and 3-year overall survival rate(OS) in patients with stage Ⅱb-Ⅲb cervical cancer were analyzed.Results:There were significant differences in tumor differentiation and tumor size between the sensitive group and the insensitive group(P<0.05).There was no significant difference in age,FIGO stage,lymph node metastasis and chemotherapy regimen between the two groups(P>0.05).The total effective rate of concurrent chemoradiotherapy in patients with KLF6 protein low expression was significantly lower than that in patients with high expression(P<0.05).The total effective rate of patients with p21 protein low expression was significantly higher than that of patients with high expression(P<0.05).The expressions of KLF6 and p21 protein were correlated with FIGO stage,tumor differentiation,tumor size and chemoradiotherapy sensitivity of Ⅱb-Ⅲb stage cervical cancer patients(P<0.05).OS in patients with KLF6 low expression was significantly lower than that in patients with high expression(P<0.05).OS in patients with high p21 expression was significantly lower than that in patients with low expression(P<0.05).Multivariate analysis showed that KLF6 and p21 expressions were independent risk factors for the prognosis of patients(P<0.05).Conclusion:Ⅱb-Ⅲb stage cervical cancer patients with KLF6 high expression and low p21 expression are sensitive to concurrent chemoradiotherapy,and the total effective rate of chemoradiotherapy and 3-year OS were higher,which can be used as the basis for prognosis judgement.
作者
车亚
郭峰
任英红
马红兵
Che Ya;Guo Feng;Ren Yinghong;Ma Hongbing(Department of Radiotherapy,Shangluo Central Hospital,Shaanxi Shangluo 726000,China;Department of Radiotherapy,Second Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Xi'an 710004,China)
出处
《现代肿瘤医学》
CAS
2020年第8期1346-1350,共5页
Journal of Modern Oncology
