Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan,
Ann Surg Oncol. 2014 Feb;21(2):597-604. doi: 10.1245/s10434-013-3220-2. Epub 2013 Sep 25.
Neoadjuvant chemoradiotherapy (NACRT) for esophageal squamous cell carcinoma (ESCC) is beneficial in the setting of a complete pathological response. Rad51 expression affects both chemo- and radiosensitivity in many cancers; however, its role in ESCC is unclear.
Rad51 expression was investigated by immunohistochemical staining with resected specimens in 89 ESCC patients who underwent surgery without preoperative therapy. The association with Rad51 and clinicopathological factors was assessed. The expression of Rad51 was also investigated in pretreatment biopsy specimens in 39 ESCC patients who underwent surgery after NACRT and compared with the pathological response to NACRT.
Lymph node metastasis was more frequently observed in Rad51-positive cases than negative cases (58.5 vs. 30.6%, P = 0.0168) in patients treated with surgery alone. Disease-specific survival was decreased in Rad51-positive cases compared to Rad51-negative cases (5 year survival: 79.6 vs. 59.3%, P = 0.0324). In NACRT patients, completed pathological responses were more frequently observed in Rad51-negative cases than in Rad51-positive cases (68.8 vs. 46.5%, P = 0.0171).
Rad51 expression in ESCC was associated with lymph node metastasis and poor survival. Additionally, Rad51 expression in pretreatment biopsy specimens was a predictive factor for the response to NACRT.
新辅助放化疗（NACRT）对食管鳞癌（ESCC）有益，完全病理缓解时获益最大。Rad51 在许多癌症中影响化疗和放疗敏感性；然而，其在 ESCC 中的作用尚不清楚。
采用免疫组织化学染色法检测 89 例未接受术前治疗的手术患者的切除标本中 Rad51 的表达，评估 Rad51 与临床病理因素的相关性。对 39 例接受 NACRT 后手术的 ESCC 患者的术前活检标本进行 Rad51 表达检测，并与 NACRT 的病理反应进行比较。
单独手术治疗的患者中，Rad51 阳性病例的淋巴结转移发生率高于阴性病例（58.5%比 30.6%，P=0.0168）。Rad51 阳性病例的疾病特异性生存率低于 Rad51 阴性病例（5 年生存率：79.6%比 59.3%，P=0.0324）。在 NACRT 患者中，Rad51 阴性病例较 Rad51 阳性病例更易发生完全病理缓解（68.8%比 46.5%，P=0.0171）。
ESCC 中 Rad51 的表达与淋巴结转移和不良预后相关。此外，术前活检标本中 Rad51 的表达是 NACRT 反应的预测因素。
