Clinical significance of GLUT-1 expression in patients with esophageal cancer treated with concurrent chemoradiotherapy
Clinical significance of GLUT-1 expression in patients with esophageal cancer treated with concurrent chemoradiotherapy
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DOI：
10.3892/ol.2010.199
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发表时间：
2011-01-01
期刊：
影响因子：
2.9
通讯作者：
Murayama, Sadayuki
中科院分区：
文献类型：
--
作者：
Chiba, Itaru;Ogawa, Kazuhiko;Murayama, Sadayuki
本研究旨在探讨食管癌术前活检组织中葡萄糖转运蛋白-1（GLUT-1）的表达是否可预测接受同步放化疗（CRT）的食管癌患者的临床结局。共25例食管癌患者接受同期CRT治疗。放射治疗的总剂量为40-66.6戈伊（中位数66.6戈伊），单次剂量为1.8-2戈伊。化疗方面，顺铂（80 mg/m2，第1天）和5-氟尿嘧啶（800 mg/m2，第2-6天）与放疗同时使用，每3-4周1次，共1-2个疗程。在同步CRT之前，通过活检从25例食管癌患者中获得组织样本，并使用免疫组化染色进行GLUT-1表达的半定量分析。在25例患者中的7例（28%）中观察到高GLUT-1表达，并且GLUT-1表达与临床T分期（p=0.0454）、临床N分期（p=0.0324）和对CRT的初始反应（p=0.0185）显著相关。GLUT-1高表达患者的局部控制（LC）（5年LC 28.6%）明显低于低表达患者（5年LC 73.4%，p <0.05）。多因素分析显示GLUT-1和化疗疗程数是影响LC预后的独立因素。GLUT-1高表达患者的无复发生存率（RFS）显著低于GLUT-1低表达患者（p=0.0405）。多因素分析显示GLUT-1、化疗疗程数和临床M分期是RFS的独立预后因素。GLUT-1表达与临床T分期、临床N分期和同步CRT的初始反应显著相关，并可预测同步CRT治疗的食管癌患者的LC和RFS。
This study aimed to investigate whether glucose transporter-1 (GLUT-1) expression in a pretreatment esophageal cancer biopsy was predictive of clinical outcomes in patients with esophageal cancer undergoing concurrent chemoradiotherapy (CRT). A total of 25 patients with esophageal cancer treated with concurrent CRT were reviewed. Radiotherapy was administered up to total doses of 40-66.6 Gy (median 66.6 Gy) with a single fraction of 1.8-2 Gy. Regarding chemotherapy, cisplatin (80 mg/m(2) on day 1) and 5-fluorouracil (800 mg/m(2) on days 2-6) were used concurrently with radiotherapy, every 3-4 weeks for a total of 1-2 courses. Tissue samples from esophageal carcinoma were obtained from the 25 patients by biopsy prior to concurrent CRT, and a semiquantitative analysis of GLUT-1 expression was performed using immunohistochemical staining. High GLUT-1 expression was observed in 7 of 25 (28%) patients, and GLUT-1 expression was significantly correlated with clinical T stage (p=0.0454), clinical N stage (p=0.0324) and initial response to CRT (p=0.0185). Patients with a high GLUT-1 expression had significantly poorer local control (LC) (5-year LC 28.6%) than those with a low expression (5-year LC 73.4%, p < 005). Multivariate analysis revealed that GLUT-1 and the number of chemotherapy courses were independent prognostic factors for LC. Patients with a high GLUT-1 expression had significantly lower recurrence-free survival (RFS) compared to those with a low GLUT-1 expression (p=0.0405). Multivariate analysis revealed that GLUT-1, the number of chemotherapy courses and clinical M stage were independent prognostic factors for RFS. GLUT-1 expression was significantly correlated with clinical T stage, clinical N stage and initial response to concurrent CRT, and was predictive of LC and RFS for patients with esophageal cancer treated with concurrent CRT.