Dou Xue, Wang Ren-Ben, Meng Xiang-Jiao, Yan Hong-Jiang, Jiang Shu-Mei, Zhu Kun-Li, Xu Xiao-Qing, Chen Dong, Song Xian-Rang, Mu Dian-Bin
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong Academy of Medical Sciences, University of Jinan, Jinan, China E-mail :
Asian Pac J Cancer Prev. 2014;15(2):825-30. doi: 10.7314/apjcp.2014.15.2.825.
The purpose of this study was to examine the role of programmed cell death 4 (PDCD4) expression in predicting tumor response to neoadjuvant chemoradiotherapy and outcomes for patients with locally advanced rectal cancer.
Clinicopathological factors and expression of PDCD4 were evaluated in 92 patients with LARC treated with nCRT. After the completion of therapy, 4 cases achieved clinical complete response (cCR), and thus the remaining 88 patients underwent a standardized total mesorectal excision procedure. There were 38 patients (41.3%) with a good response (TRG 3-4) and 54 (58.7%) with a poor one (TRG 0-2).
Immunohistochemical staining analyses showed that patients with high expression of PDCD4 were more sensitive to nCRT than those with low PDCD4 expression (P=0.02). High PDCD4 expression before nCRT and good response (TRG3-4) were significantly associated with improved 5-year disease-free survival and 5-year overall survival (P<0.05). Multivariate analysis demonstrated that the pretreatment PDCD4 expression was an independent prognostic factor.
Our study demonstrated that high expression of PDCD4 protein is a useful predictive factor for good tumor response to nCRT and good outcomes in patients with LARC.
本研究旨在探讨程序性细胞死亡4（PDCD4）表达在预测局部晚期直肠癌患者新辅助放化疗疗效及预后中的作用。
对92例接受新辅助放化疗的局部晚期直肠癌患者的临床病理因素及PDCD4表达进行评估。治疗结束后，4例患者达到临床完全缓解（cCR），其余88例患者接受了标准化的全直肠系膜切除术。38例患者（41.3%）反应良好（肿瘤退缩分级[TRG]为3 - 4级），54例患者（58.7%）反应较差（TRG为0 - 2级）。
免疫组织化学染色分析显示，PDCD4高表达患者对新辅助放化疗的敏感性高于PDCD4低表达患者（P = 0.02）。新辅助放化疗前PDCD4高表达且反应良好（TRG3 - 4）与5年无病生存率和5年总生存率的提高显著相关（P < 0.05）。多因素分析表明，治疗前PDCD4表达是一个独立的预后因素。
我们的研究表明，PDCD4蛋白高表达是局部晚期直肠癌患者对新辅助放化疗肿瘤反应良好及预后良好的有用预测因素。
