调强放疗联合或不联合化疗后鼻咽癌耐药蛋白的变化及其与临床病理特征和短期预后的相关性

Alterations of drug-resistant proteins in nasopharyngeal carcinoma after intensity-modulated radiation therapy with or without chemotherapy and correlation with clinicopathologic features and short-term prognosis.

作者信息

Wang GaoFeng, Li Yuan

机构信息

Department of Otorhinolaryngology, The Fourth People's Hospital of Lin'an District, Hangzhou City, 311321, Zhejiang Province, China.

Department of Otolaryngology, The Affiliated Hospital of Hangzhou Normal University (Hangzhou Second People's Hospital), No.126, Wenzhou Road, Hangzhou City, 310015, Zhejiang Province, China.

出版信息

Discov Oncol. 2025 May 23;16(1):874. doi: 10.1007/s12672-025-02677-y.

DOI:10.1007/s12672-025-02677-y

PMID:40407950

Abstract

OBJECTIVE

The aim of this study was to investigate the alteration of drug-resistant proteins in nasopharyngeal carcinoma (NPC) after intensity-modulated radiation therapy (IMRT) with or without chemotherapy and its correlation with clinicopathologic features and short-term prognosis.

METHODS

Eligible NPC patients receiving IMRT with or without chemotherapy were studied. Tumor tissues from patients before treatment and at 2/3 of IMRT were obtained, and drug resistance proteins, P-glycoprotein (P-gp), multidrug resistance-associated protein (MRP), lung resistance protein (LRP), and glutathione S-transferase π (GST-π) were detected. Meanwhile, the clinicopathological data of the patients were collected and statistically analyzed. The short-term prognosis of the patients was observed and recorded, and the correlation between progression-free survival (PFS) and positive drug-resistant proteins was analyzed.

RESULTS

Before treatment, the positive rates of P-gp, MRP, LRP, and GST-π among the 43 NPC patients were 30.23%, 16.28%, 20.93%, and 34.88%, respectively; after treatment, the positive rates of P-gp and MRP were 65.12% and 41.86%, respectively (P-gp, P < 0.001; MRP, P = 0.009). Significantly higher positive rates of P-gp were observed only after treatment than before treatment in the IMRT-alone group (n = 18) and IMRT/chemotherapy group (n = 25). The intensity of P-gp, MRP and GST-π positive expression was increased in patients treated with IMRT/chemotherapy compared to pre-treatment. No correlation between positive expression of drug-resistant proteins and lymphatic metastasis was observed. Patients with P-gp and GST-π positivity had a more pronounced decrease in PFS.

CONCLUSION

P-gp, MRP, and GST-π are increased in NPC patients after IMRT with or without chemotherapy and are closely associated with poor short-term prognosis of patients.

摘要

目的

本研究旨在探讨鼻咽癌（NPC）患者在接受调强放射治疗（IMRT）联合或不联合化疗后耐药蛋白的变化及其与临床病理特征和短期预后的相关性。

方法

对接受IMRT联合或不联合化疗的符合条件的NPC患者进行研究。获取患者治疗前及IMRT治疗至2/3疗程时的肿瘤组织，检测耐药蛋白P-糖蛋白（P-gp）、多药耐药相关蛋白（MRP）、肺耐药蛋白（LRP）和谷胱甘肽S-转移酶π（GST-π）。同时收集患者的临床病理资料并进行统计学分析。观察并记录患者的短期预后，分析无进展生存期（PFS）与耐药蛋白阳性表达之间的相关性。

结果

治疗前，43例NPC患者中P-gp、MRP、LRP和GST-π的阳性率分别为30.23%、16.28%、20.93%和34.88%；治疗后，P-gp和MRP的阳性率分别为65.12%和41.86%（P-gp，P < 0.001；MRP，P = 0.009）。仅在单纯IMRT组（n = 18）和IMRT/化疗组（n = 25）中，观察到治疗后P-gp的阳性率显著高于治疗前。与治疗前相比，接受IMRT/化疗的患者中P-gp、MRP和GST-π阳性表达的强度增加。未观察到耐药蛋白阳性表达与淋巴转移之间的相关性。P-gp和GST-π阳性的患者PFS下降更为明显。