摘要
目的探讨胰腺癌人平衡型核苷酸转运体1(hENT1)蛋白的表达与吉西他滨化疗疗效、不良反应及预后的关系。方法收集2013年6月至2016年1月间嘉兴市第二医院肝胆胰外科及嘉兴市中医院肝胆胰外科收治的83例胰腺癌患者经内镜超声下细针穿刺活检的组织。采用免疫组织化学法检测hENT1蛋白的表达,分为hENT1低表达组和高表达组;依据化疗的疗效分为吉西他滨有效组和耐药组。比较两组患者的临床病理参数、不良反应发生率、中位生存期和无进展生存率(PFS)。结果 83例胰腺癌组织中37例(44.6%)hENT1高表达,46例(55.4%)低表达。吉西他滨化疗疗效与患者的性别、年龄、临床症状及肿瘤原发部位、肿瘤大小、TNM分期、CA19-9水平、CEA水平、有无肝脏转移均无相关性,但hENT1高表达组的吉西他滨耐药率显著高于低表达组(78.1%比50.0%),差异有统计学意义(P=0.010)。两组患者均可以耐受吉西他滨化疗不良反应,无化疗相关性死亡,但hENT1低表达组患者白细胞、血小板减少发生率显著高于hENT1高表达组(63.0%比21.6%,47.8%比16.2%),差异均有统计学意义(P值均<0.05)。hENT1低表达组中位生存期和1年PFS均显著低于高表达组(11个月比15个月,19.4%比50.0%),差异均有统计学意义(P值均<0.05)。结论胰腺癌组织中hENT1蛋白表达下降降低了患者对吉西他滨化疗的疗效,增加患者白细胞、血小板减少的发生率。
Objectives To investigate the relationship between the expression of hENT1 protein in pancreatic cancer and the efficacy, adverse reactions and prognosis of gemcitabine. Methods The tissues of 83 patients with pancreatic cancer diagnosed in Department of Hepatobiliary and Pancreatic Surgery of Jiaxing Second Hospital and Jiaxing City Hospital of Traditional Chinese Medicine from June 2013 to January 2016 were collected by endoscopic fine needle aspiration biopsy. The expression of hENT1 protein was detected by immunohistochemistry, which was divided into hENT1 low expression group and high expression group. According to the curative effect of chemotherapy, it was divided into gemcitabine effective group and drug resistance group. The clinicopathological parameters, adverse reaction rate, median survival, and progression-free survival (PFS) were compared between the two groups. Results Of the 83 pancreatic cancer tissues, 37(44.6%) had high expression of hENT1 and 46(55.4%) had low expression. There were no significant correlations of the efficacy of gemcitabine chemotherapy with gender, age, clinical symptoms, primary tumor location, tumor size, TNM staging, CA19-9 level, CEA level, presence or absence of liver metastasis, but gemcitabine resistance rate in high expression group was significantly higher than the low expression group (78.1% vs 50.0%), and the difference was statistically significant (P=0.010). Both groups were able to tolerate adverse reactions of gemcitabine chemotherapy and no chemotherapy-related death was observed, but the incidence of leucopenia and thrombocytopenia in hENT1 low expression group was significantly higher than those in hENT1 protein high expression group (63.0% vs 21.6%, 47.8% vs 16.2%), the differences was statistically significant (all P<0.05). The median survival and 1-year PFS of hENT1 protein low expression group were significantly lower than those of high expression group (11 months vs 15 months, 19.4% vs 50%), and the differences were statistically significant (P<0.05).
作者
张怡
杨晓丹
王晓光
吴斌
倪全法
宋政炜
费建国
Zhang Yi;Yang Xiaodan;Wang Xiaoguang;Wu Bin;Ni Quanfa;Song Zhengwei;Fei Jianguo(Jiaxing City Hospital of Traditional Chinese Medicine, Jiaxing 314000, China;Department of Hepatobiliary and Pancreatic Surgery of Jiaxing Second Hospital, Jiaxing 314000, China)
出处
《中华胰腺病杂志》
CAS
2019年第2期103-106,共4页
Chinese Journal of Pancreatology
基金
嘉兴市科技局社会发展项目(2014AY21031-1).
关键词
胰腺肿瘤
平衡型核苷酸转运体1
吉西他滨
预后
Pancreatic neoplasms
Balanced nucleotide transporter1
Gemcitabine
Prognosis
