ISSN:
1437-7772
Schlagwort(e):
Key words Esophageal carcinoma
;
Chemotherapy
;
p53
;
p21
;
bcl-2
;
bax
Quelle:
Springer Online Journal Archives 1860-2000
Thema:
Medizin
Notizen:
Abstract Background. Chemotherapy is an important component of the multimodal approach to the treatment of advanced esophageal squamous cell carcinoma. Methods. We investigated the associations between p53, p21 (Waf1), bcl-2, and bax expression and response to chemotherapy (cisplatin + 5-fluorouracil + leucovorin) in 43 patients with advanced esophageal squamous cell carcinoma. The expression of p53, p21 (Waf1), bcl-2, and bax proteins was analyzed immunohistologically in pretreatment biopsy and post-treatment resected specimens. Results. The 23 patients who had objective evidence of either a complete response (CR) or a partial response (PR) to chemotherapy survived for significantly longer than the 20 patients who had no response (NR). The expression of p53, p21 (Waf1), bcl-2, and bax was detected in 26 (61%), 12 (28%), 6 (14%), and 19 (44%) of the pretreatment biopsy specimens, respectively. The response to chemotherapy was not independently associated with the expression of any of these proteins. However, in the 26 patients with p53-expressing tumors, the response rate was 80% in patients whose tumor also expressed p21, whereas it was 19% in those whose tumor did not coexpress p21. No change in p53 expression was observed before and after chemotherapy, except in 1 patient; however, p21 expression appeared to be induced by chemotherapy in 5 patients. Patient survival was also not independently associated with the expression of any of these proteins. However, patients with p53-negative or p21-positive tumors had a better response to chemotherapy and survived for longer than those with p53-positive and p21-negative tumors. Conclusion. p53 and p21 expression in biopsy specimens obtained before chemotherapy could be useful predictors of response and survival in patients with advanced esophageal squamous cell carcinoma.
Materialart:
Digitale Medien
URL:
http://dx.doi.org/10.1007/s101470050097
Permalink