Dou Xue, Wang Renben, Meng Xiangjiao, Yan Hongjiang, Jiang Shumei, Zhu Kunli, Xu Xiaoqing, Chen Dong, Song Xianrang, Mu Dianbin
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong Academy of Medical Sciences, University of Jinan, Jinan, Shandong, China.
Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong Academy of Medical Sciences, University of Jinan, Jinan, Shandong, China.
Cancer Biomark. 2015;15(2):181-8. doi: 10.3233/CBM-140452.
At present no useful factors to predict the sensitivity to neoadjuvant chemoradiotherapy (nCRT) have been established in patients with locally advanced rectal cancer (LARC).
The objective of this study was to explore the prognostic role of T cell factor 4 (TCF4) expression in predicting tumor response to nCRT and tumor outcomes for patients with LARC.
The study enrolled 96 patients who underwent nCRT followed by total mesorectal excision (TME). The TCF4 expression of all patients' biopsies before nCRT was evaluated by Immunohistochemical staining method.
After completion of nCRT, 5 cases (5.2%) achieved clinical complete response (cCR) thus the remaining 91 patients underwent a standardized total mesorectal excision (TME) procedure. There were 44 patients (45.8%) achieved good tumor response (including TRG 3-4 and 5 cCR patients) while poor response (TRG 0-2) was achieved in 52 patients (54.2%). Our results demonstrated that patients with low expression of TCF4 were more sensitive to nCRT than those with high TCF4 expression (P=0.031). Low TCF4 expression before nCRT and good response were significantly associated with improved 5-year disease-free survival and 5-year overall survival (P<0.05). Multivariate analysis confirmed that the pretreatment TCF4 expression was an independent prognostic factor.
Our data revealed that low TCF4 protein expression was a useful predictive factor of good tumor response to nCRT and good outcomes in patients with LARC.
目前，在局部晚期直肠癌（LARC）患者中，尚未确立预测新辅助放化疗（nCRT）敏感性的有效因素。
本研究旨在探讨T细胞因子4（TCF4）表达在预测LARC患者对nCRT的肿瘤反应及肿瘤预后中的作用。
本研究纳入96例行nCRT后行全直肠系膜切除术（TME）的患者。采用免疫组织化学染色法评估所有患者在nCRT前活检组织中的TCF4表达。
nCRT完成后，5例（5.2%）达到临床完全缓解（cCR），其余91例患者接受了标准化的全直肠系膜切除术（TME）。44例患者（45.8%）获得良好的肿瘤反应（包括TRG 3 - 4和5例cCR患者），而52例患者（54.2%）反应较差（TRG 0 - 2）。我们的结果表明，TCF4低表达的患者比TCF4高表达的患者对nCRT更敏感（P = 0.031）。nCRT前TCF4低表达及良好反应与5年无病生存率和5年总生存率的提高显著相关（P < 0.05）。多因素分析证实，术前TCF4表达是独立的预后因素。
我们的数据显示，TCF4蛋白低表达是LARC患者对nCRT有良好肿瘤反应及良好预后的有用预测因素。
