目的:探讨β—tubulinIII在食管癌组织中的表达,分析其与食管癌生物学行为的关系,及根据其表达结果制定个体化化疗方案的疗效。方法:应用免疫组化(SP)法检测β-tubulinIII在55例食管癌组织中的阳性表达,采用X^2检验方法分析其阳性表达与肿瘤临床病理学特征之间的关系。依据低表达(阴性)对紫杉类抗微管药物相对敏感,选用紫杉醇联合顺铂方案;高表达(阳性)相对不敏感的原则,选择吉西他滨联合顺铂方案。对照组选用紫杉醇联合顺铂化疗方案。比较两组客观缓解率(ORR)及疾病控制率(DCR)的差异,及无进展生存时间(PFS)和中位生存期(MST)的差异。结果:B—tubulinIII在55例食管癌组织中阳性表达为16例(29.09%),在肿瘤组织中的表达与食管癌的浸润深度、淋巴结转移及肿瘤分期相关(P〈0.05),而与年龄、性别、组织学分化程度无关(P〉0.05)。实验组ORR为54.55%(30/55)优于对照组32.50%(13/40),x^2=-4.543,P=0.033;DCR为69.09%(38/55)优于对照组47.50%(19/40),xZ=-4.498,P=0.034。差异有统计学意义。实验组与对照组的PFS分别为5.2月和4.5月(x^2=4.215,P=0.040),MST分别为8.9月和7.4月(x^2=6.146,P=0.013),差异有统计学意义。结论:食管癌细胞存在β-mbulin III的表达,且与肿瘤细胞的浸润深度、淋巴结转移及临床分期相关。检肿瘤标本中13-tubulinⅢ表达,有助于为实施个体化化疗提供一种选择药物的方法。
Objective: To identify the expression of β-tubulin III in esophageal carcinoma and relationship to the biological behavior of esophageal carcinoma, and to know the curative effect of individualized chemotherapy based on the gene expression. Methed: The expression of [3-tubulin III were detected by immunohistochemistry SP method in 55 esophageal carcinoma tissues, the relationship be- tween the clinicopathological features and the expressions of-tubulin III were analyzed. Selecting individualized chemotherapy combinded with two kinds of drugs based on the expression results, with the principle that low (negative) expression in tumor is sensitive anti-microtubule drugs, selected chemotherapy scheme combinded with paclitaxel and cisplatin; higher (positive) expression is relative low sensitivity, selected gemcitabine and cisplatin. In control group, the chemotherapy scheme combinded with paclitaxel and cisplatin was selected. The differences of curative effect rate and clinical benefit rate of the two groups were compared. Result: The positive rates of β-tubulin III ex- pression in esophageal carcinoma tissues was 29.09%, the positive rates had relationship to the depth of tumor infiltration, lymph node metastasis and clinical stage (P〈0.05), had no relationship to age, sex and the degree of histological differentiation of the patients (P〉0.05). The Objective Response Rate (ORR) and the disease control rate (DCR) of experimental group were better than the control group (54.55 % vs 32.50%, x~-4.543; 69.09%vs 47.50%0, x2=-4.498; respectively P〈0.05 for each). The median PFS of the experimental group was 5.2 months and the control group was 4.5 months, showing significant difference (x~-4.215, P=0.040). The MST of the two groups re- spectively was 8.9 months and 7.4 months, with significant difference (x2=-6.146,P=0.013). Conclusion: The detection of β-tubulin III in esophageal carcinoma tissues had relationship to the depth of tumor infiltration, lymph node metastas