Yu Pengfei, Cheng Xiangdong, Du Yian, Yang Litao, Huang Ling
Department of Abdominal Surgery, Zhejiang Cancer Hospital, Hangzhou, China.
J Cancer Res Ther. 2015 Jan-Mar;11(1):46-50. doi: 10.4103/0973-1482.147695.
Post-operative adjuvant chemotherapy was beneficial for some patients; however, it may increase the treatment burden and reduce the immunity of other patients. Screening appropriate patients based on molecular markers for individualized adjuvant chemotherapy was necessary.
Between June 2002 and June 2004, 119 patients who underwent radical gastrectomy were retrospectively analyzed. Some patients had adjuvant chemotherapy based on platinum and 5-FU for four to six cycles. Topoisomerase II (ToPo II) negative, multidrug resistance protein (MRP) positive, and glutathione S-transferase π (GST-π) positive were regarded as three risk factors that may be associated with chemotherapy resistance and poor prognosis. Patients were divided into two groups: high-risk group (≥ 2 risk factors) and the low-risk group (<2 risk factors), and the tumor recurrence and patient survival time of the two groups were analyzed.
The average recurrence time of the low-risk group was significantly longer than that of the high-risk group (21.29 ± 11.10 versus 15.16 ± 8.05 months, P < 0.01).The 3-year and 5-year survival rate of the high-risk group was 57.4% and 42.6%; however, it had no significant difference compared to 66.2% and 58.5% of the low-risk group (P > 0.05). In the high-risk group, the 3-year survival rate of patients with/without chemotherapy were 62.1% and 52.0%, 5-year survival rates were 44.8% and 40.0%, respectively, but the difference was not statistically significant (P > 0.05). In the low-risk group, the 3-year survival rate of patients with/without chemotherapy were 81.2% and 51.5%, and the 5-year survival rates were 71.9% and 45.5%, respectively, and the differences were statistically significant (P < 0.05).
Multidrug resistance (MDR)-related proteins ToPo II, MRP, and GST-ð had great significance for the individualized post-operative chemotherapy and prognosis of gastric cancer.
术后辅助化疗对部分患者有益；然而，它可能会增加治疗负担并降低其他患者的免疫力。基于分子标志物筛选合适的患者进行个体化辅助化疗很有必要。
回顾性分析2002年6月至2004年6月期间119例行根治性胃切除术的患者。部分患者接受了以铂类和5-氟尿嘧啶为基础的辅助化疗，共四至六个周期。拓扑异构酶II（ToPo II）阴性、多药耐药蛋白（MRP）阳性和谷胱甘肽S-转移酶π（GST-π）阳性被视为可能与化疗耐药和预后不良相关的三个危险因素。患者分为两组：高危组（≥2个危险因素）和低危组（<2个危险因素），分析两组的肿瘤复发情况和患者生存时间。
低危组的平均复发时间显著长于高危组（21.29±11.10对15.16±8.05个月，P<0.01）。高危组的3年和5年生存率分别为57.4%和42.6%；然而，与低危组的66.2%和58.5%相比，差异无统计学意义（P>0.05）。在高危组中，接受/未接受化疗患者的3年生存率分别为62.1%和52.0%，5年生存率分别为44.8%和40.0%，但差异无统计学意义（P>0.05）。在低危组中,接受/未接受化疗患者的3年生存率分别为81.2%和51.5%，5年生存率分别为71.9%和45.5%，差异有统计学意义（P<0.05）。
多药耐药（MDR）相关蛋白ToPo II、MRP和GST-ð对胃癌个体化术后化疗及预后具有重要意义。
