肿瘤异常蛋白在宫颈癌患者同步放化疗中的变化及临床意义

Variation of tumor abnormal protein in concurrent radiotherapy and chemotherapy of patients with cervical cancer and its clinical significance

摘要:

目的 探讨宫颈癌放化疗过程中肿瘤异常蛋白（TAP）的动态变化，TAP 与患者临床特征和预后之间的关系。方法 选取2012 年4 月-2015 年4 月于江苏大学附属人民医院收治的89 例局部晚期宫颈癌患者，所有患者均接受同步放化疗，具体为外照射联合腔内放疗，同步化疗方案为顺铂单药（40 mg/m2），1 次/ 周。分别于放化疗前、中不同时间及放化疗后检测TAP，对比分析TAP 放化疗前后的动态变化，并分析其TAP 与患者临床特征及2 年生存率的相关性。结果 TAP 与阴道侵犯情况、肿块大小、淋巴结转移情况及临床分期相关（P <0.05），治疗前TAP 阳性率为65/89（73.0%），治疗结束后为38/89（42.7%），差异有统计学意义（P <0.05）；放化疗后的TAP 均与患者的2 年生存率密切相关（P <0.05），进一步Cox 回归分析显示，临床分期及放化疗后TAP 阳性是宫颈癌的预后因子。结论 TAP 能反映局部晚期宫颈癌患者的疾病进展程度，且能作为判断预后的指标。

Abstract:

Objective To investigate the dynamic changes of abnormal protein Tumor (TAP) in cervical cancer during concurrent chemoradiotherapy, and the relationships between TAP and clinical features and prognosis analysis of patients with cervical cancer. Methods A total of 89 patients with locally advanced cervical cancer were enrolled in this study from April 2012 to April 2015 in our hospital. All the patients received concurrent chemoradiotherapy. Radiotherapy was carried out with external radiotherapy and brachytherapy, concurrent chemotherapy with cisplatin(40 mg/m2, weekly), TAP was detected in different time points pre- , intro- and post- chemoradiotherapy, the dynamic changes of TAP pre- and post- chemoradiotherapy were compared and analyzed, and the relationships between TAP and clinical features and 2-year survival rate were further analyzed. Results TAP was significantly correlated with vaginal invasion, tumor size, lymph node metastasis and clinical stage (P < 0.05), the positive rate of TAP preand post- treatment was 65/89 (73.0%) and 27/89 (30.3%), respectively; the difference was statistically significant(P < 0.05). TAP status after chemoradiotherapy were closely related to 2-year survival rate of the patients (P < 0.05).Further analysis of Cox regression showed that TAP after chemoradiotherapy and clinical stage were independent prognostic factors of cervical cancer. Conclusion TAP can reflect the degree of disease progression in patients with locally advanced cervical cancer, which can be used as a prognostic factor.