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[新辅助化疗对胃癌微卫星不稳定性的影响]

[Influence of neoadjuvant chemotherapy on microsatellite instability in gastric carcinoma].

作者信息

Sun Xiao-Wei, Zhan You-Qing, Li Wei, Xu Li, Li Jin-Tian, Chen Xiao-Jun, Zhang Ru-Hua, Xu Da-Zhi

机构信息

State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. R. China.

出版信息

Ai Zheng. 2006 Dec;25(12):1493-6.

Abstract

BACKGROUND & OBJECTIVE: Most results from clinical trials of neoadjuvant chemotherapy for gastric carcinoma are certain. Meanwhile, microsatellite instability (MSI) is thought to be a new mechanism of cell canceration. This study was to investigate the influence of neoadjuvant chemotherapy on MSI in gastric carcinoma.

METHODS

Two microsatellite loci D2S123 and D3S1298 in tumor samples from 48 patients with gastric carcinoma, received preoperative chemotherapy of 5-fluorouracil (5-FU) and leucovorin (CF), were analyzed by polymerase chain reaction (PCR), electrophoresis on 8% denatured polyacrylamide gel, and silver staining. The microsatellite statuses of preoperative and postoperative specimens were compared. Chi-square test was used to analyze the influence of neoadjuvant chemotherapy on MSI in gastric carcinoma.

RESULTS

The detection rate of MSI was significantly higher in preoperative samples than in postoperative samples (31.3% vs. 12.5%, P=0.026). After neoadjuvant chemotherapy, 9 cases changed from MSI-positive to MSI-negative, while no MSI-negative cases became MSI-positive.

CONCLUSION

The neoadjuvant chemotherapy regimen of 5-FU/CF can induce some MSI-positive gastric carcinoma change to MSI-negative, but has no effect on MSI-negative cases.

摘要

背景与目的

胃癌新辅助化疗的多数临床试验结果已确定。同时,微卫星不稳定性(MSI)被认为是细胞癌变的一种新机制。本研究旨在探讨新辅助化疗对胃癌中MSI的影响。

方法

采用聚合酶链反应(PCR)、8%变性聚丙烯酰胺凝胶电泳及银染法,分析48例接受5-氟尿嘧啶(5-FU)和亚叶酸钙(CF)术前化疗的胃癌患者肿瘤样本中的两个微卫星位点D2S123和D3S1298。比较术前和术后标本的微卫星状态。采用卡方检验分析新辅助化疗对胃癌中MSI的影响。

结果

术前样本中MSI的检出率显著高于术后样本(31.3%对12.5%,P = 0.026)。新辅助化疗后,9例从MSI阳性变为MSI阴性,而无MSI阴性病例变为MSI阳性。

结论

5-FU/CF新辅助化疗方案可使部分MSI阳性胃癌转变为MSI阴性,但对MSI阴性病例无效。

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