Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan.
Anticancer Res. 2013 Apr;33(4):1463-71.
Definitive chemoradiotherapy (dCRT) has been established as the standard treatment for esophageal squamous cell carcinoma (ESCC). However, many patients develop persistent or recurrent disease following dCRT. We investigated factors related to chemoradioresistance and treatment outcomes in patients with ESCC who underwent salvage esophagectomy after dCRT.
We selected 38 patients with persistent disease and 24 with recurrent disease who underwent salvage esophagectomy after dCRT, immunolocalized p53, p16, p27, murine double minute 2 (MDM2), cyclin D1, Ki-67, and epidermal growth factor receptor, and correlated the findings with clinicopathological features.
MDM2 positivity was significantly higher among patients with persistent disease than among those with recurrent disease (p<0.0001). In addition, negative p16 expression was a predictor of poor prognosis among patients with persistent disease.
MDM2 overexpression plays an important role in chemoradioresistance of ESCC; furthermore, negative p16 expression can predict poor prognosis of patients with persistent disease.
确定性放化疗（dCRT）已被确立为治疗食管鳞癌（ESCC）的标准治疗方法。然而，许多患者在接受 dCRT 后仍会出现持续性或复发性疾病。我们研究了在接受 dCRT 后行挽救性食管切除术的 ESCC 患者中与放化疗耐药性和治疗结果相关的因素。
我们选择了 38 例疾病持续存在和 24 例疾病复发的患者，这些患者在接受 dCRT 后行挽救性食管切除术，免疫组化定位了 p53、p16、p27、鼠双微体 2（MDM2）、细胞周期蛋白 D1、Ki-67 和表皮生长因子受体，并将这些发现与临床病理特征相关联。
持续性疾病患者的 MDM2 阳性率明显高于复发性疾病患者（p<0.0001）。此外，p16 表达阴性是持续性疾病患者预后不良的预测因素。
MDM2 过表达在 ESCC 的放化疗耐药中起重要作用；此外，p16 表达阴性可预测持续性疾病患者的不良预后。
