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预测酒精相关癌症患者预后的生物标记物

By LabMedica International staff writers
Posted on 07 Mar 2018
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图片:用髓过氧化物酶抗体染色的人胃腺癌样本(图片蒙罗氏生命科学公司惠赐)。
图片:用髓过氧化物酶抗体染色的人胃腺癌样本(图片蒙罗氏生命科学公司惠赐)。
摄入酒精被认定为胃癌等癌症的可改变风险因子。摄入的酒精可能降低核糖核酸聚合酶III (POLR3)的水平,造成氧化损伤,进而诱发胃癌。

一份新报告阐明了特定的蛋白质如何与酒精相互作用以及这种相互作用如何影响接受含铂辅助化疗的胃癌患者的生存和反应,这些患者可能仍在饮酒,也可能不在饮酒。

位于合肥的安徽医科大学的科学家分析了77名患者的肿瘤组织样本和69份取自肿瘤区外的组织样本,他们因原发性胃腺癌接受了手术。其中66名患者接受了根除手术,57名患者接受了含铂辅助化疗。77名患者全部接受了平均为期18个月的随访,期间94% (62/66)的患者疾病复发。他们保持无病的平均期限为14个月(无病存活期,DFS),而总体存活期(OS)的中值为20个月。

科研小组发现,转录因子IIB相关因子1 (BRF1)、乳腺癌易感基因1/2 (BRCA1/2)和髓过氧化物酶(MPO)也有助于预测哪些患者将更多得益于含铂辅助化疗。例如,接受化疗患者的DFS延长了两倍或更多,且未发现BRCA1/2或其表达水平很低。无BRCA1或BRCA1表达水平低的患者无病的平均期限为18个月,而高表达组的平均无病期限为9个月。MPO阴性患者也有更佳的预后趋势,尽管统计意义不显著。

研究人员发现,酒精一直对患者产生有害作用。胃癌患者的饮酒习惯如果有危险或有害,会更常出现BRF1表达水平高以及MPO阳性炎性细胞滤过的情况。酗酒者更常出现肿瘤外组织内BRCA1的范围异常。这些研究人员此前的研究发现,乳腺癌和肝癌患者的BRF1 水平与酒精摄入之间也有类似的关联。

该研究的论文发表于2018年1月10日的《美国病理杂志》(The American Journal of Pathology)。联合资深作者Hua Wang博士说:“摄入酒精是已知的胃癌风险因子,中国胃癌的患病程度和致死率很高。我们发现了与DNA修复相关的因子——BRF1、BRCA1/2和MPO对于胃癌患者有很好的预后价值,无论他们有没有饮酒习惯。再者,这些蛋白质也影响着含铂辅助化疗对胃癌患者如何起作用。”

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