【摘要】 目的探讨进展期胃癌中β-tubulinⅢ和survivin的表达与多西紫杉醇化疗耐药性关系。方法回顾性分析74例接受多西紫杉醇化疗的晚期胃癌患者的临床病理资料。免疫组织化学法检测肿瘤标本β-tubulinⅢ和survivin蛋白的表达,并对疗效、不良反应进行分析。结果β-tubulinⅢ阳性表达率为37.8%(28/74),survivin阳性表达率为58.1%(43/74),均与性别、年龄及组织类型无关。化疗有效率(CR+PR)为54.10%,β-tubulinⅢ(+)的患者有效率低(32.14%),β-tubulinⅢ(-)患者有效率高(69.57%),差异有显著性(P<0.05)。Survivin(+)组的有效率为32.56%,低于survivin(-)组的67.74%,差异有显著性(P<0.05)。联合检测显示:β-tubulinⅢ(+)且survivin(+)组有效率为25.0%,中位疾病无进展期为4.1个月,1年、2年生存率分别为35.0%、15.0%,β-tubulinⅢ(-)且survivin(-)组有效率为73.91%,中位疾病无进展期为7.8个月,1年、2年生存率分别为56.5%、30.4%,差异均有显著性(P<0.05)。最常见的不良反应为骨髓抑制、消化道反应。结论β-tubulinⅢ和survivin高表达的进展期胃癌患者对多西紫杉醇化疗耐药。更多还原

【Abstract】 Objective To investigate the relationship between the expression of β-tubulinⅢ,survivin protein and chemoresistance to docetaxel in advanced gastric cancer.Methods Seventy-four patients of advanced gastric cancer treated with docetaxel were enrolled in this study and their tumor samples were collected retrospectively for analysis.The expression of β-tubulinⅢ,survivin protein in tumor samples was detected by the immunohistochemical methods.The data of therapeutical effect and toxicity were collected and analyzed.Results The β-tubulinⅢ positive staining accounted for 37.8%(28/74).The survivin positive staining accounted for 58.1%(43/74).There was no correlation between β-tubulinⅢ,survivin positive expression and age,gender,pathological type.The response rate(CR+PR)was 54.10%.Patients with over-expression of β-tubulinⅢ had less response rate(32.14% vs 69.57%) to docetaxel(P<0.05).Patients with over-expression of survivin had less respeme rate(32.56% vs 67.74%) to docetaxel(P<0.05).Patients with over-expression of β-tubulinⅢ and survivin had also lower response rate(25.0% vs 73.91%,P<0.05).Patients with over-expression of β-tubulinⅢ and survivin had also lower the median time to progress and 1-and 2-year survival rates(4.1m vs 7.8 m,35.0% vs 56.5%,15.0% vs 30.4%,P<0.05).The mainside-effects were myelosuppression and digestive apparatus toxicity.Conclusion Over-expression of β-tubulinⅢ,survivin in tumor cells was associated with resistance to docetaxel in patients with advanced gastric cancer receiving docetaxel-based chemotherapy.更多还原