Wallin Asa R, Svanvik Joar, Adell Gunnar, Sun Xiao-Feng
Department of Oncology, Institute of Biomedicine and Surgery, University of Linköping, Linköping, Sweden.
Int J Radiat Oncol Biol Phys. 2006 Jun 1;65(2):452-8. doi: 10.1016/j.ijrobp.2005.12.043. Epub 2006 Apr 19.
PRL-3 (phosphatase of regenerating liver) is involved in metastasis of colorectal cancer; however, its therapeutic implication in cancer patients has not been studied. We investigated the relationships of PRL expression to radiotherapy (RT) in rectal cancer patients.
Phosphatase of regenerating liver expression was immunohistochemically examined in distant (n = 36) and adjacent (n = 82) normal mucosa, primary tumor (n = 125), biopsy specimens (n = 96), and lymph node metastasis (n = 30) from rectal cancer patients participating in a clinical trial of preoperative RT.
Phosphatase of regenerating liver expression was increased from the distant to adjacent mucosa and to the primary tumor (p < 0.05). PRL was highly expressed at the invasive margin in 28% of the primary tumors and 26% of the metastases. In the RT group, strong PRL expression at the invasive margin was related to distant recurrence (p = 0.006) and poor survival (p = 0.01), but not in the non-RT group. The survival significance remained even after adjusting for Dukes' stage and differentiation (p = 0.02). Additional multivariate analyses showed that the correlation with prognostic significance of PRL differed between the RT and non-RT groups (p = 0.01).
Phosphatase of regenerating liver expression (rather than PRL-3 alone) at the invasive margin predicted resistance to RT and unfavorable survival in rectal cancer patients with preoperative RT.
再生肝脏磷酸酶(PRL-3)参与结直肠癌转移;然而,其在癌症患者中的治疗意义尚未得到研究。我们调查了直肠癌患者中PRL表达与放疗(RT)的关系。
对参与术前RT临床试验的直肠癌患者的远处(n = 36)和相邻(n = 82)正常黏膜、原发肿瘤(n = 125)、活检标本(n = 96)及淋巴结转移灶(n = 30)进行免疫组织化学检测再生肝脏磷酸酶的表达。
再生肝脏磷酸酶的表达从远处黏膜到相邻黏膜再到原发肿瘤逐渐升高(p < 0.05)。28%的原发肿瘤和26%的转移灶在浸润边缘PRL高表达。在RT组中,浸润边缘PRL强表达与远处复发(p = 0.006)及不良生存(p = 0.01)相关,但在非RT组中无此关联。即使在调整Dukes分期和分化程度后,生存意义依然存在(p = 0.02)。进一步的多因素分析显示,RT组和非RT组中PRL与预后意义的相关性不同(p = 0.01)。
浸润边缘的再生肝脏磷酸酶表达(而非单独的PRL-3)预示着接受术前RT的直肠癌患者对RT耐药及生存不良。