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山东大学学报(医学版) ›› 2011, Vol. 49 ›› Issue (7): 125-.

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术前新辅助放化疗对食管癌原发灶病理形态学及Ki-67表达的影响

贾慧1,2,于金明2,宋平平3,张为迪3,穆殿斌4,韩大力2,张锡芹2   

  1. 1.山东大学医学院, 济南 250012; 2.山东省肿瘤医院放疗科, 山东省放射肿瘤学重点实验室, 济南 250117;
    3.山东省肿瘤医院胸外科, 济南 250117; 4.山东省肿瘤医院病理科, 济南 250117
  • 收稿日期:2011-03-15 出版日期:2011-07-10 发布日期:2011-07-10
  • 通讯作者: 于金明(1958- ),男,研究员,博士生导师,主要从事肿瘤放疗临床与基础研究。 E-mail:yujinmingsd@yahoo.com.cn
  • 作者简介:贾慧(1979- ),女,主治医师,博士研究生,主要从事肿瘤的综合治疗研究。
  • 基金资助:

    山东省自然科学基金资助课题(Y2007C121)。

Expression of Ki-67 and pathomorphological response after preoperative  chemoradiotherapy in patients with esophageal cancer

JIA Hui1,2, YU Jin-ming2, SONG Ping-ping3, ZHANG Wei-di3, MU Dian-bin4, HAN Da-li2, ZHANG Xi-qin2   

  1. 1. School of Medicine,  Shandong University, Jinan 250012, China;  2. Department of Radiation Oncology,
    Shandong Tumor Hospital, Shandong Province Key Laboratory of Radiation Oncology, Jinan 250117, China;
    3. Department of Thoracic Surgery, Shandong Tumor Hospital, Jinan 250117, China;
    4. Department of Pathology, Shandong Tumor Hospital, Jinan 250117, China
  • Received:2011-03-15 Online:2011-07-10 Published:2011-07-10

摘要:

目的       研究术前新辅助放化疗对食管肿瘤病理形态学改变及对食管癌细胞增殖的影响,并探讨二者之间的关系。方法      选择40例食管鳞癌初治患者,治疗前经食管镜活检病理确诊,行新辅助放化疗加根治性手术治疗,术后常规进行手术标本病理学检查,免疫组化染色分别检测治疗前活检标本和手术标本Ki-67表达的标记指数。结果      放化疗后重度反应者12例(30.0% ),中度反应20例(50.0%),轻度反应8例(20.0%)。显著有效率30.0%,总有效率80.0%。放化疗前、后食管鳞癌组织中Ki-67表达的标记指数差异有统计学意义(P<0.01);重、中度放化疗反应组放化疗前、后Ki-67标记指数的差异有统计学意义(P<0.01);轻度反应组放化疗前Ki67标记指数与放化疗后存在差异,但差异无统计学意义(P>0.05)。结论      多数食管癌患者接受新辅助放化疗后仍有肿瘤病灶存在,约20%的患者肿瘤组织退缩不明显。放化疗前后食管鳞癌组织中Ki67表达的标记指数明显下降,提示放化疗后肿瘤的增殖能力较放化疗前下降。

关键词: 食管肿瘤;放化疗;病理反应;Ki-67;增殖

Abstract:

 Objective       To investigate the effect of preoperative radiochemotherapy on proliferation and alteration of primary lesion pathology in esophageal carcinoma. Methods     40 patients with esophageal carcinoma enrolled into this study received biopsy by an esophagoscope prior to treatment and then preoperative adjuvant radiochemotherapy and surgical treatment. Expression of the Ki-67 protein in both biopsy and postoperative specimens was detected by immunohistochemical staining technique. Results     After surgery, 8(20%) patients were detected with tumor regression in a mild degree, 20(50%) in a moderate degree, and 12 (30%) in a severe degree. The overall response rate was 80%. Expression of Ki-67, as a predictive marker of response to preoperative chemoradiotherapy for esophageal cancers, was significantly correlated with tumor regression. Expression of Ki67 was significantly decreased in tumors with severe response to preoperative treatment, when compared to those with moderate and mild responses (P<0.01). Expression ofKi67 in the slightly shrank group was lower after radiochemotherapy than that before radiochemotherapy, while the difference was not significant (P>0.05). Conclusion         There are still relict tumor cells after radiochemotherapy in most patients with esophageal carcinoma, about 20% of which are detected without significant tumor regression. Expression level of Ki-67 in esophageal carcinoma tissues significantly descends after radiochemotherapy, which may imply proliferation and invasion of the tumor decrease.

Key words: Esophageal neoplasms; Radiochemotherapy; Pathology response; Ki-67; Proliferation

中图分类号: 

  • R735.1
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