【摘要】 背景与目的:拓扑异构酶Ⅱα(topoisomeraseⅡα,TopoⅡα)是真核细胞中与DNA复制、修复等密切相关的一种蛋白酶,在多种肿瘤中TopoⅡα的表达水平与预后有关。本文探讨鼻咽癌组织中拓扑异构酶Ⅱα的表达与临床病理特征及其与预后的关系。方法:应用免疫组化法检测114例鼻咽癌患者的鼻咽肿瘤组织中TopoⅡα的表达。按TopoⅡα的表达水平将患者分为两组,用Kaplan-Meier法分析TopoⅡα的表达与肿瘤根治性放疗后复发、转移的关系。用多因素Cox模型分析患者复发的相关因素。结果:TopoⅡα在鼻咽癌组织中表达从0～90%不等,平均(22.63±21.92)%,以大于或等于20%的癌细胞表达TopoⅡα为阳性的判断标准,则阳性率为43.9%(50/114)。在不同性别、年龄、不同的WHO病理分型以及各T分期、N分期、临床分期的患者中,TopoⅡα的表达率无显著性差异(P>0.05)。TopoⅡα表达阴性组和阳性组患者的3年无复发生存率分别为93.1%vs74.3%(P=0.0027);3年无病生存率分别为77.9%vs58.9%(P=0.0091);3年无远处转移生存率分别为81.1%vs77.6%(P=0.566);多因素Cox模型分析筛选出TopoⅡα的表达是独立的与复发相关的因素,TopoⅡα阳性者无复发生存时间短。结论:部分鼻咽癌组织中存在TopoⅡα的高表达,TopoⅡα高表达的患者治疗后局部复发率较高更多还原

【Abstract】 BACKGROUND & OBJECTIVE: TopoisomeraseⅡα (TopoⅡα) is a protei n in eukaryotic cell with many different roles in DNA duplication and repair. It was reported that the expression level of TopoⅡα was related to the prognosi s of many malignant tumors. The aim of this study was to investigate the relati onship of expression of TopoⅡα in nasopharyngeal carcinoma (NPC) with clinico pathologic factors and its prognostic significance. METHODS:The expression of To poⅡα was observed in 114 NPC cases using immunohistochemical staining. All of the patients were divided into two groups according to the expression level of TopoⅡα. Kaplan-Meier survival analysis was used to analyze the relationship o f expression of TopoⅡα with recurrence and metastasis of tumor after radiothe rapy. Cox proportional hazards model analysis was used to analyze the factors re lated to local recurrence of tumor. RESULTS: The expression of TopoⅡα in NPC cells ranged from 0 to 90%; the average percentage was (22.63±21.92)%. The po sitive rate of TopoⅡα was 43.9% (50/114) when 20% was used as the cut-of f point. The positive rate of TopoⅡα was not related to the sex, age, patholo gical type, and clinical staging. The 3-year relapse-free survival rates of ne gative group and positive group were 93.1% and 74.3%, respectively (P=0.0027) . The 3-year disease-free survival rates of the two groups were 77.9% and 58 .9%, respectively (P=0.0091). The metastasis-free survival rates of the two gr oups were 81.1% and 77.6%, respectively (P=0.566). Cox proportional hazards m odel analysis showed that the local recurrence of tumor was independently affect ed by the expression of TopoⅡα. CONCLUSION: There is a high expression level o f TopoⅡα in a part of NPC.NPC patients with high expression of TopoⅡα have a higher local recurrence rate and worse prognosis.更多还原