Grimminger Peter, Vallböhmer Daniel, Hoffmann Andreas, Schulte Christian, Bollschweiler Elfriede, Schneider Paul M, Hölscher Arnulf H, Metzger Ralf, Brabender Jan
Department of General-, Visceral-, and Tumor-Surgery, University of Cologne, 50931Cologne, Germany.
J Surg Oncol. 2009 Nov 1;100(6):447-51. doi: 10.1002/jso.21355.
Analysis of survivin RNA expression in peripheral blood as a non-invasive molecular predictor of response to neoadjuvant radiochemotherapy in patients with locally advanced cancer of the esophagus.
Blood samples were drawn from 29 patients with esophageal cancer prior to neoadjuvant radiochemotherapy. After extraction of cellular tumor-RNA from blood samples, quantitative expression analysis of survivin was done by quantitative real-time RT-PCR.
Twenty of 29 (69%) of patients showed a minor histopathological response and 9 of 29 (31%) showed a major-response to neadjuvant radiochemotherapy. RNA expression in blood of patients was detectable for survivin in 27.6%, and in 100% for beta-actin. The mean survivin expression was not significantly different between minor- and major-responders. No significant associations were detected between survivin expression levels and patients clinical variables. A high expression level for survivin was significantly associated with a minor-response to neoadjuvant treatment (P = 0.042). Relative survivin expression levels above 0.15 were not associated with major histopathological response (sensitivity: 35%; specificity: 100%).
Minor-response to the applied therapy was significantly associated with a high survivin RNA expression level in patient's blood. Survivin appears to be a specific non-invasive predictor of response to neoadjuvant therapy in esophageal cancer.
分析外周血中生存素RNA表达，作为局部晚期食管癌患者新辅助放化疗反应的非侵入性分子预测指标。
在新辅助放化疗前，从29例食管癌患者采集血样。从血样中提取细胞肿瘤RNA后，通过定量实时逆转录聚合酶链反应对生存素进行定量表达分析。
29例患者中，20例（69%）对新辅助放化疗显示轻微组织病理学反应，9例（31%）显示主要反应。患者血液中生存素的RNA表达在27.6%的患者中可检测到，β-肌动蛋白在100%的患者中可检测到。轻微反应者和主要反应者的生存素平均表达无显著差异。未检测到生存素表达水平与患者临床变量之间存在显著关联。生存素高表达水平与新辅助治疗的轻微反应显著相关（P = 0.042）。生存素相对表达水平高于0.15与主要组织病理学反应无关（敏感性：35%；特异性：100%）。
对所应用治疗的轻微反应与患者血液中生存素RNA高表达水平显著相关。生存素似乎是食管癌新辅助治疗反应的特异性非侵入性预测指标。
