Apoptosis index correlates with chemotherapy efficacy and predicts the survival of patients with gastric cancer
Apoptosis index correlates with chemotherapy efficacy and predicts the survival of patients with gastric cancer
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细胞凋亡指数与化疗疗效相关并预测胃癌患者的生存
DOI：
10.1007/s13277-012-0357-8
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发表时间：
2012-08-01
期刊：
影响因子：
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通讯作者：
Ji, Jiafu
中科院分区：
文献类型：
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作者：
Jia, Yongning;Dong, Bin;Ji, Jiafu
本研究的目的是探讨胃癌新辅助化疗后细胞凋亡的变化及其与疗效的关系。纳入了2006年1月至2007年12月期间67例cT 2 -4或TanyN 1 - 3 M0的胃癌患者。所有患者既往均行胃切除术和D2淋巴结切除术，并进行了根治性治疗。所有患者均推荐接受12个周期的术前mFOLFOX 7化疗，83例患者仅接受辅助化疗。切除的标本进行原位TUNEL检测，并用Applied Imaging Ariol SL-50扫描。术前化疗组（CS组）的凋亡指数（AI）明显高于术前未化疗组（S组）。CS组AI与病理反应呈显著正相关（rho = 0.403，P = 0.0002）。ROC曲线显示49.4分作为缓解的AI截止值，将CS组分为两个具有显著不同预后的亚组（P= 0.003），并进一步允许根据病理学缓解评估（P= 0.022）在48例评估为1a-b级的患者中识别出8例预后显著更好的患者。结论：胃癌患者术前化疗的有效性和新辅助化疗后的预后与AI相关。缓解的AI临界值可用作当前病理学缓解评价的补充方法，以帮助识别潜在的缓解者。
The objectives of this study are to investigate the apoptotic changes in gastric adenocarcinoma following neoadjuvant chemotherapy and to illuminate its correlation with response. One 67 gastric cancer patients with cT2-4 or TanyN1-3M0 between January 2006 and December 2007 were included. All patients had previous gastrectomy and D2 lymphadenectomy with curative intent performed. A total of 12 cycles of preoperative mFOLFOX7 chemotherapy was recommended for all patients, and 83 patients received only adjuvant chemotherapy. Resected specimens were subjected to in situ TUNEL assay and scanned with Applied Imaging Ariol SL-50. Apoptosis index (AI) was significantly higher in the patient received preoperative chemotherapy (CS group) than in the patient did not (S group). In the CS group, AI was found to have a strong positive correlation with the pathological response (rho = 0.403,P= 0.0002). A ROC curve presented a score of 49.4 as the AI cutoff value for response, dividing the CS group into two subgroups with significantly different prognoses (P= 0.003) and further allowing identification of 8 patients with significantly better prognosis out of 48 patients evaluated as grades 1a–b according to a pathological response evaluation (P= 0.022). In conclusion, AI is correlated with efficacy of preoperative chemotherapy and prognosis of gastric cancer patients following neoadjuvant chemotherapy. An AI cutoff value for response may be used as a complementary approach to current pathological response evaluations to help identify potential responders.