來自曼徹斯特大學(xué)的團(tuán)隊(duì)發(fā)現(xiàn)膀胱腫瘤患者有較高水平的蛋白質(zhì)HIF-1α,更有可能受益于一種治療方法,即在放療的同時(shí)給予患者混和氧(95%O2、5%CO2的混合氣體)和煙酰胺片。這種治療方法被稱為"CON",能使放射放療更有效。
通過比較,單獨(dú)放療或放療與CON聯(lián)合治療患者腫瘤組織樣本中HIF-1α的水平,研究人員發(fā)現(xiàn)該蛋白能預(yù)測哪些患者受益于CON。當(dāng)患者接受放療和CON,高濃度的蛋白質(zhì)與疾病更好的生存有關(guān)聯(lián)。低蛋白水平患者并沒有受益于CON與組合放射治療。
doi:10.1038/bjc.2014.315
PMC:
PMID:
Expression hypoxia-inducible factor-1α predicts benefit from hypoxia modification in invasive bladder cancer
Hunter, BA et al.
Background:
The addition of carbogen and nicotinamide (CON) to radiotherapy (RT) improves overall survival in invasive bladder cancer. We explored whether expression of the hypoxia marker hypoxia-inducible factor-1α (HIF-1α) alone or in combination with other markers predicted benefit from CON.
Methods:
A retrospective study was carried out using material from patients with high-grade invasive bladder carcinoma enrolled in the BCON phase III trial of RT alone or with CON (RT+CON). HIF-1α expression was studied in 137 tumours using tissue microarrays and immunohistochemistry. Data were available from other studies for carbonic anhydrase IX and glucose transporter 1 protein and gene expression and tumour necrosis.
Results:
Patients with high HIF-1α expression had improved 5-year local relapse-free survival with RT+CON (47%) compared with RT alone (21%; hazard ratio (HR) 0.48, 95% CI 0.26-0.8, P=0.02), no benefit was seen with low HIF-1α expression (HR 0.81, 95% CI 0.43-1.50, P=0.5). Combinations of markers including necrosis also predicted benefit but did not improve on prediction using necrosis alone.
Conclusions:
HIF-1α may be used to predict benefit from CON in patients with bladder cancer but does not improve on use of necrosis.
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腫瘤科藥師溫馨提醒:膀胱癌的發(fā)病是一個(gè)多因素混合、多基因參與、多步驟形成的過程,異?;蛐偷姆e累加上外在環(huán)境的作用終導(dǎo)致惡性表型的出現(xiàn)。
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