Immunohistochemical analysis of tumour regression grade for rectal cancer after neoadjuvant chemoradiotherapy
Immunohistochemical analysis of tumour regression grade for rectal cancer after neoadjuvant chemoradiotherapy
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DOI：
10.1111/j.1463-1318.2010.02386.x
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发表时间：
2011-09-01
影响因子：
3.4
通讯作者：
Cejas, P.
中科院分区：
文献类型：
--
作者：
Moreno Garcia, V.;Batlle, J. F.;Cejas, P.
目的Rodel等提出的肿瘤消退分级（TRG）已被用作直肠癌术前放化疗（CRT）后的独立预后因素。TRG 2和3的测定，分别半定量定义为肿瘤消退大于或小于50%，似乎与预后无关。本研究的目的是找到一种免疫组化模式，以允许改善无病（DFS）和总生存期（OS）定义的中间反应者的分层。（表皮生长因子受体），VEGF（血管内皮生长因子），CD133抗体，使用组织微阵列（TMA）对来自88名患者的治疗后手术标本进行p53抗体和Ki67抗体的评估。结果中位随访40个月时，TRG是DFS（P = 0.05）和OS（P = 0.001）的独立预测因子，但TRG 2和3之间在DFS（P = 0.74）和OS（P = 0.41）方面无差异。TMA的结果显示，由CD133表达阴性构成的中间应答者的化学预后不良。然而，当检查CD133表达在整个部分，有一个中间的相关性与TMA和预后的意义losed.Conclusion结果并没有证实免疫组化在预测直肠癌患者的预后的价值后，新辅助放化疗。这就质疑了TMA在这种情况下检测CD133表达的准确性。
Aim Tumour regression grade (TRG) as defined by Rodel et al. has been used as an independent prognostic factor for rectal carcinoma after preoperative treatment by chemoradiotherapy (CRT). Determination of TRG 2 and 3, semiquantitatively defined as more or less than 50% tumour regression, respectively, does not appear to correlate with prognosis. The purpose of this study was to find an immunohistochemical pattern to permit improved stratification of intermediate responders defined by disease free (DFS) and overall survival (OS).Method Immunohistochemistry of EGFR (epidermal growth factor receptor), VEGF (vascular endothelial growth factor), CD133 antibody, p53 antibody and Ki67 antibody was evaluated using tissue microarrays (TMA) on post-treatment surgical specimens from 88 patients. CD133 expression was confirmed in the whole section when available.Results At a median follow-up of 40 months, TRG was found to be an independent predictor of DFS (P = 0.05) and OS (P = 0.001) but no differences were found between TRG 2 and 3 in terms of DFS (P = 0.74) or OS (P = 0.41). The results of TMA showed an immunohistochemically poor prognostic profile for intermediate responders configured by negativity of CD133 expression. However, when examining CD133 expression in the whole section, there was an intermediate correlation with TMA and the prognostic significance was lost.Conclusion The results did not confirm the value of immunohistochemistry in predicting the prognosis of patients with rectal cancer following neoadjuvant chemoradiotherapy. This questions the accuracy of TMA in detecting CD133 expression in this setting.