CAJ | 학술논문

目的：探讨PTNE蛋白表达对于西妥昔单抗联合化疗治疗转移性结直肠癌疗效的影响。方法初诊的晚期结直肠癌患者，共纳入经分子病理学证实KRAS野生型、同时接受过西妥昔单抗联合化疗的患者共51例，应用免疫组织化学法（ S－P法）检测肿瘤组织中PTEN蛋白的表达。分析PTNE蛋白表达与患者临床病理特征及疗效的关系。结果51例患者中，25例患者一线接受了西妥昔单抗联合化疗，26例患者二线接受了西妥昔单抗联合化疗。25例患者获得部分缓解（PR），占49．0％；19例患者病情稳定（SD），占37．3％；疾病控制率（DCR）86．3％。中位生存时间22．0个月。 PTEN阳性表达30例（58．8％）。 PTEN表达与病理分级有关（P＝0．015）；PTEN阳性的患者DCR 93．3％（28／30），PTEN阴性者DCR 66．7％（14／21），PTEN表达与DCR有关（P＝0．035）。单因素分析显示，不同ECOG PS评分、PTEN状态对中位总生存时间（OS）的影响差异有统计学意义（P＝0．032，P＝0．026）；Cox多因素分析提示ECOG PS评分及PTEN状态是晚期KRAS野生型的结直肠癌患者接受西妥昔单抗治疗独立疗效预后因素。结论 KARS野生型晚期结直肠癌患者PTEN蛋白检测可能有助于预测西妥昔单抗联合化疗的疗效。
목적：탐토PTNE단백표체대우서타석단항연합화료치료전이성결직장암료효적영향。방법초진적만기결직장암환자，공납입경분자병이학증실KRAS야생형、동시접수과서타석단항연합화료적환자공51례，응용면역조직화학법（ S－P법）검측종류조직중PTEN단백적표체。분석PTNE단백표체여환자림상병리특정급료효적관계。결과51례환자중，25례환자일선접수료서타석단항연합화료，26례환자이선접수료서타석단항연합화료。25례환자획득부분완해（PR），점49．0％；19례환자병정은정（SD），점37．3％；질병공제솔（DCR）86．3％。중위생존시간22．0개월。 PTEN양성표체30례（58．8％）。 PTEN표체여병리분급유관（P＝0．015）；PTEN양성적환자DCR 93．3％（28／30），PTEN음성자DCR 66．7％（14／21），PTEN표체여DCR유관（P＝0．035）。단인소분석현시，불동ECOG PS평분、PTEN상태대중위총생존시간（OS）적영향차이유통계학의의（P＝0．032，P＝0．026）；Cox다인소분석제시ECOG PS평분급PTEN상태시만기KRAS야생형적결직장암환자접수서타석단항치료독립료효예후인소。결론 KARS야생형만기결직장암환자PTEN단백검측가능유조우예측서타석단항연합화료적료효。
Objective To determine the relationship between the level of phosphatase and tensin homolog deleted on chromosome ten ( PTEN) and the efficacy of cetuximab in combined with chemotherapy to treat metastatic colorectal canc-er ( mCRC) .Methods A total of 51 mCRC patients who were initially diagnosed in our hospital from January 2007 to December 2012 were included in the current study.They were identified as wild-type KRAS carriers and treated with cetuximab in combination with chemotherapy.Then, the levels of PTEN in tumor tissues were determined by immunohis-tochemistry ( IHC) .Results Among these patients were 25 patients who received first-line cetuximab combined with chemotherapy, and 26 patients who underwent second -line cetuximab combined with chemotherapy.The partial re-sponse (PR) rate was 49.0% (25/51).There were 19 patients with stable disease (SD).The disease control rate (DCR) was 86.3%(44/51).The median overall survival was 22.0 months.The positive expression rate of PTEN was 58.8%(30/51), which was correlated with histological grade (P=0.015).The DCR was 93.3%(28/30) for PTEN positive patients and 66.7% (14/21) for PTEN negative patients.The quantity of PTEN was related with DCR ( P=0.035).According to analysis of variance, the effects of RCOG performance status (PS) scores and PTEN level on me-dian overall survival were statistically different (P=0.032 and P=0.026, respectively).Multivariate COX regression a-nalysis showed that ECOG PS scores and PTEN level were independent prognostic factors for mCRC patients with wild-type KRAS receiving cetuximab combined with chemotherapy.Conclusion Detection of PTEN in mCRC patients with wild-type KRAS is beneficial for predicting the efficacy of cetuximab combined with chemotherapy.