COX2 Expression Predicts Resistance to Chemoradiotherapy in Esophageal Squamous Cell Carcinoma
COX2 Expression Predicts Resistance to Chemoradiotherapy in Esophageal Squamous Cell Carcinoma
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DOI：
10.1245/s10434-011-1645-z
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发表时间：
2011-10-01
影响因子：
3.7
通讯作者：
Matsubara, Hisahiro
中科院分区：
文献类型：
--
作者：
Akutsu, Yasunori;Hanari, Naoyuki;Matsubara, Hisahiro
目的。环氧合酶（COX）2的过度表达与癌发生、肿瘤进展和预后相关，并且COX2表达增加与放射抵抗相关。然而，COX2 表达与食管鳞状细胞癌放化疗耐药之间尚无相关性。本研究的目的是评价COX2表达是否是食管鳞癌放化疗耐药的指标以及COX2作为CRT生物标志物的可行性。方法。本系列研究纳入了 58 名通过活检样本诊断为食管鳞状细胞癌的患者。所有患者均在新辅助治疗中接受同步放化疗，然后进行根治性食管切除术。通过免疫组织化学染色评估COX2表达，并与手术切除标本的组织病理学结果进行统计比较。结果。 COX2弱表达的应答率为87%，中度表达为62%，强表达为30%，并且COX2表达与应答率之间存在密切相关性（Kendall's tau b = 0.396，P = 0.001）。在单变量分析中，发现 COX2 的阴性或弱表达与 CRT 反应显着相关（比值比，6.296；95% 置信区间 (CI)，1.58-25.096；P = 0.010）。在多变量分析中，发现COX2的弱表达（30％或更少）是一个独立的预后因素（比值比，6.534；95％CI，1.535-27.803；P = 0.011）。结论。 COX2的表达可预测食管鳞癌对放化疗的耐药性，也是评估CRT反应的可行生物标志物。
Purpose. The overexpression of cyclooxygenase (COX)2 is correlated with carcinogenesis, tumor progression, and prognosis, and increased COX2 expression is correlated with radiation resistance. However, no correlation between the COX2 expression and resistance to chemoradiotherapy for esophageal squamous cell carcinoma has been characterized. The purpose of the present study was to evaluate whether COX2 expression is an indicator of resistance to chemoradiotherapy in esophageal squamous cell carcinoma and the feasibility of COX2 as a biomarker for CRT.Methods. Fifty-eight patients who were diagnosed with esophageal squamous cell carcinoma from biopsy samples were enrolled in the present series. All patients underwent concurrent chemoradiotherapy in a neoadjuvant setting, followed by radical esophagectomy. COX2 expression was evaluated by immunohistochemical staining and statistically compared with the histopathologic findings in surgically resected specimens.Results. The rate of responders was 87% for weak expression of COX2, 62% for moderate expression, and 30% for strong expression, and there was a close correlation between COX2 expression and the response rate (Kendall's tau b = 0.396, P = 0.001). In the univariate analysis, negative or weak expression of COX2 was found to correlate significantly with CRT response (odds ratio, 6.296; 95% confidence interval (CI), 1.58-25.096; P = 0.010). In the multivariate analysis, weak expression of COX2 (30% or less) was found to be an independent prognostic factor (odds ratio, 6.534; 95% CI, 1.535-27.803; P = 0.011).Conclusions. The COX2 expression predicts resistance to chemoradiotherapy in esophageal squamous cell carcinoma, and it also is a feasible biomarker for evaluating the CRT response.