本文選題：鼻咽腫瘤 + 表皮生長(zhǎng)因子受體��； 參考：《濟(jì)南大學(xué)》2011年碩士論文

【摘要】：目的:生物分子標(biāo)志物已經(jīng)廣泛應(yīng)用于腫瘤的診斷、分期及判斷復(fù)發(fā)等,并且已有研究表明治療前分子標(biāo)志物的表達(dá)能夠預(yù)測(cè)多種腫瘤的療效和預(yù)后。為進(jìn)一步提高鼻咽癌患者的療效,探討有效分子標(biāo)記物表皮生長(zhǎng)因子受體(EGFR)和轉(zhuǎn)移抑制基因(nm23)表達(dá)與鼻咽癌(NPC)患者放療敏感性及預(yù)后的相關(guān)性,為評(píng)估其對(duì)鼻咽癌患者預(yù)后的預(yù)測(cè)價(jià)值提供可靠的臨床依據(jù),并指導(dǎo)靶向藥物等個(gè)體化治療方案的選擇。 方法:回顧分析本院2003—2006年放療前行鼻咽活檢且資料完整的127例經(jīng)病理證實(shí)的鼻咽癌患者,所有患者均采用6MV X線調(diào)強(qiáng)適形放療聯(lián)合順鉑+氟尿嘧啶方案化療。采用免疫組化鏈霉素抗生物素蛋白-過氧化物酶法(SP)檢測(cè)活檢標(biāo)本中EGFR和nm23表達(dá),隨訪5年并用Kaplan-Meier法、Log-rank檢驗(yàn)分析EGFR、nm23表達(dá)與局部晚期鼻咽癌患者預(yù)后的關(guān)系。 結(jié)果:EGFR和nm23在鼻咽癌活檢標(biāo)本中的陽性表達(dá)率分別為80.3%和47.2%。EGFR不同表達(dá)與鼻咽癌患者放療敏感性相關(guān)(χ2=5.19,P=0.023)。nm23不同表達(dá)與鼻咽癌患者發(fā)生遠(yuǎn)處轉(zhuǎn)移相關(guān)(χ2=7.03,P=0.008)。全組患者5年局部控制率、總生存率(OS)、無瘤生存率(DFS)分別為58.3%、53.5%、46.5%。EGFR陰性者5年OS、DFS比陽性者高(χ2=8.23,P=0.004;χ2=5.25,P=0.022),nm23陽性者5年OS、DFS均比陰性者高(χ2=15.68,P=0.000;χ2=14.85,P=0.000)。Cox回歸模型多因素分析顯示分期、EGFR及nm23表達(dá)均可作為判斷鼻咽癌患者預(yù)后的因素(χ2=23.027、18.331、39.916,P=0.000、0.000、0.000)。 結(jié)論:放療前EGFR和nm23表達(dá)與鼻咽癌患者預(yù)后密切相關(guān),可作為預(yù)測(cè)鼻咽癌患者的預(yù)后因素,指導(dǎo)臨床治療方案的選擇;其中EGFR表達(dá)陽性者及nm23表達(dá)陰性者預(yù)后較差,需配合靶向藥物等更積極的治療。
[Abstract]:Objective: biomolecular markers have been widely used in the diagnosis, staging and recurrence of tumors, and it has been shown that the expression of molecular markers before treatment can predict the curative effect and prognosis of many kinds of tumors. In order to improve the curative effect of nasopharyngeal carcinoma (NPC) patients, the expression of epidermal growth factor receptor (EGFR) and metastasis suppressor gene (nm23) was investigated in patients with nasopharyngeal carcinoma (NPC). In order to evaluate the prognostic value of nasopharyngeal carcinoma (NPC) patients, it can provide reliable clinical basis and guide the choice of individualized treatment schemes such as targeted drugs. Methods: a total of 127 patients with nasopharyngeal carcinoma confirmed by pathology before radiotherapy from 2003 to 2006 were retrospectively analyzed. All patients were treated with 6MV intensity modulated radiotherapy combined with cisplatin fluorouracil regimen. The expression of EGFR and nm23 in biopsy specimens was detected by immunohistochemical streptomycin avidin-peroxidase method. The relationship between the expression of EGFR rnm23 and the prognosis of locally advanced nasopharyngeal carcinoma was analyzed by Kaplan-Meier log-rank test for 5 years. Results the positive rates of nm23 and nm23 in NPC biopsy specimens were 80.3% and 80.3%, respectively. The different expression of 47.2%.EGFR was correlated with the radiosensitivity of NPC patients (蠂 ~ 2 / 5.19) and the distant metastasis of NPC (蠂 ~ 2 / 7.03 P ~ (0.008) P ~ (0.008)). The 5-year local control rate of all patients, 鎬葷敓瀛樼巼(OS),鏃犵槫鐢熷瓨鐜，

本文編號(hào)：1792010