HSP60 may predict good pathological response to neoadjuvant chemoradiotherapy in bladder cancer.
HSP60 may predict good pathological response to neoadjuvant chemoradiotherapy in bladder cancer.
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DOI：
10.1093/jjco/hyl121
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发表时间：
2006-11
影响因子：
2.4
通讯作者：
M. Urushibara;Y. Kageyama;T. Akashi;Y. Otsuka;T. Takizawa;M. Koike;K. Kihara
中科院分区：
文献类型：
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作者：
M. Urushibara;Y. Kageyama;T. Akashi;Y. Otsuka;T. Takizawa;M. Koike;K. Kihara
背景热休克蛋白（HSP）在细胞对应激条件的反应中发挥着至关重要的作用。研究了 HSP 在侵袭性或高危浅表性膀胱癌中的表达，以确定 HSP 是否可以预测新辅助放化疗 (CRT) 的病理反应。方法 采用免疫组织化学方法评估 54 例浸润性或高危浅表性膀胱癌患者在低剂量新辅助 CRT 之前以及随后进行根治性或部分膀胱切除术时 HSP27、HSP60、HSP70、HSP90 和 p53 的表达水平。根据 CRT 的病理反应（定义为手术标本中形态学治疗变化的比例），将患者分为两组（反应良好或反应差）。良好的反应者在三分之二或更多的肿瘤组织中表现出形态学治疗变化。相比之下，反应较差的患者只有不到三分之二的肿瘤组织发生了变化。结果通过多变量分析，发现 CRT 之前的 HSP60 阳性表达与 CRT 的良好病理反应有一定关系（P = 0.0564）。没有任何临床病理因素与 HSP60 表达水平相关。在病理反应良好的患者中，5 年病因特异性生存率为 88%，明显优于反应差的患者 (51%) (P = 0.0373)。结论 CRT 前 HSP60 阳性表达可以预测侵袭性或高危浅表性膀胱癌对低剂量新辅助 CRT 的良好病理反应。
BACKGROUND Heat shock proteins (HSPs) play crucial roles in cellular responses to stressful conditions. Expression of HSPs in invasive or high-risk superficial bladder cancer was investigated to identify whether HSPs predict pathological response to neoadjuvant chemoradiotherapy (CRT). METHODS Immunohistochemistry was used to assess expression levels of HSP27, HSP60, HSP70, HSP90 and p53 in 54 patients with invasive or high-risk superficial bladder cancer, prior to low-dose neoadjuvant CRT, followed by radical or partial cystectomy. Patients were classified into two groups (good or poor responders) depending on pathological response to CRT, which was defined as the proportion of morphological therapeutic changes in surgical specimens. Good responders showed morphological therapeutic changes in two-thirds or more of tumor tissues. In contrast, poor responders showed changes in less than two-thirds of tumor tissues. RESULTS Using a multivariate analysis, positive HSP60 expression prior to CRT was found to be marginally associated with good pathological response to CRT (P = 0.0564). None of clinicopathological factors was associated with HSP60 expression level. In the good pathological responders, the 5-year cause-specific survival was 88%, which was significantly better than survival in the poor responders (51%) (P = 0.0373). CONCLUSIONS Positive HSP60 expression prior to CRT may predict good pathological response to low-dose neoadjuvant CRT in invasive or high-risk superficial bladder cancer.