Takeuchi Kunio, Nakajima Masanobu, Miyazaki Tatsuya, Ide Munenori, Asao Takayuki, Fujita Kiníchi, Kuwano Hiroyuki
Department of General Surgical Science (Surgery I), Gunma University, Graduate School of Medicine, Gunma, Japan.
Hepatogastroenterology. 2007 Mar;54(74):367-72.
BACKGROUND/AIMS: The purposes of preoperative hyperthermoradiation (HR) therapy in advanced rectal carcinoma is to decrease the tumor mass and local recurrence after the operation and to improve long-term survival. The aim of this study was to investigate useful parameters of preoperative HR therapy in advanced rectal carcinoma.
Thirty-seven patients with primary advanced rectal carcinoma located in the lower part of the rectum were treated with preoperative HR therapy followed by a curative resection of the rectum. Immunohistochemical staining for p53 and heat shock protein (HSP) 70 was performed on biopsied specimens obtained from 24 of them.
For both p53- and HSP 70-positive tumors the effect of HR therapy was good and survival rates were better than with for other tumors, but there was no significant correlation between HSP 70 expression and the effect of HR therapy and survival rates. And there was also no significant correlation between p53 expression and the effect of HR therapy and survival rates. HR therapy had a significant effect on the G or G4 tumors compared with G1 or G2 tumors (p = 0.0277).
Immunohistochemical detection of p53 and HSP 70 expressions may be useful for hyperthermoradiosensitive patients with advanced rectal carcinoma selected for preoperative HR therapy. HR therapy had a significant effect on G3 or G4 tumors compared with G1 or G2 tumors.
背景/目的：晚期直肠癌术前热放疗（HR）的目的是减少肿瘤体积、降低术后局部复发率并提高长期生存率。本研究旨在探讨晚期直肠癌术前HR治疗的有效参数。
37例原发于直肠下段的晚期直肠癌患者接受术前HR治疗，随后进行直肠癌根治性切除术。对其中24例患者的活检标本进行p53和热休克蛋白（HSP）70的免疫组化染色。
对于p53和HSP 70均阳性的肿瘤，HR治疗效果良好，生存率高于其他肿瘤，但HSP 70表达与HR治疗效果及生存率之间无显著相关性。p53表达与HR治疗效果及生存率之间也无显著相关性。与G1或G2肿瘤相比，HR治疗对G3或G4肿瘤有显著效果（p = 0.0277）。
p53和HSP 70表达的免疫组化检测可能有助于为选择术前HR治疗的晚期直肠癌热放疗敏感患者提供参考。与G1或G2肿瘤相比，HR治疗对G3或G4肿瘤有显著效果。
