宫颈癌组织IER5与放射敏感性及临床意义研究

摘要

目的 探讨宫颈癌患者放疗前后早期快速反应基因5(IER5)蛋白表达特点及其与放射敏感性及临床疗效的相关性.方法 对2014—2015年接受同步放化疗的39例Ⅱb—Ⅲb期宫颈癌患者为研究对象,采集放疗前和接受累积2~6、10、20、30 Gy照射的宫颈癌组织,应用蛋白印迹法技术检测IER5蛋白相对表达水平.IER5蛋白表达与放射剂量相关性采用Pearson相关分析;不同放射剂量间IER5蛋白表达差异采用配对样本t检验;放射敏感组与抵抗组同一指标表达差异采用独立样本t检验;不同放射剂量IER 5蛋白表达变化与各临床指标间相关性采用重复测量方差分析.结果 宫颈癌组织10、20、30 Gy照射后IER5蛋白表达显著高于放疗前(t=3.06、4.01、6.99,P<0.01).IER5蛋白表达与不同放射剂量间存在相关关系(r=0.51,P<0.01).IER5在不同放射剂量下的蛋白表达与疗前肿瘤直径间存在交互作用(F=3.21,P<0.05),且疗前肿瘤直径<4、4~5 cm的IER5表达量随放射剂量显著变化(F=10.49、9.98,P<0.01).结论 宫颈癌患者放疗前和放疗中IER5表达有显著差异,且IER5表达随放射剂量升高而增多,提示 IER5与宫颈癌放射敏感性有关. 肿瘤越小IER5受放射后的表达变化越显著.%Objective To investigate the expression features of immediate early response gene 5 ( IER5) in patients with cervical cancer before and after radiotherapy,and to study the relationship of IER5 with radiosensitivity and clinical outcomes. Methods From 2014 to 2015,39 patients with stage Ⅱb-Ⅲb cervical cancer undergoing concurrent chemoradiotherapy were enrolled as subjects. Cervical cancer tissues were collected before and after radiotherapy with doses of 2-6,10,20,and 30 Gy. Western blotting was used to determine the relative expression of IER5 protein. Results The expression of IER5 protein in cervical cancer tissues was significantly higher after exposure to 10,20,and 30 Gy of radiation ( t=3. 06,4. 01,6. 99, P<0. 01).The expression of IER5 protein was correlated with the radiation dose (r=0. 511,P<0. 01).There was a significant interaction between the expression of IER5 protein under different doses of irradiation and the tumor size before radiotherapy (F=3. 212,P<0. 05).When the tumor diameter was<4 or 4-5 cm before treatment,the expression of IER5 had significant radiation dose-dependent variation ( F=10. 493,P<0. 01;F=9. 977,P<0. 01).However,there was no significant dose-dependent variation in the expression of IER5 protein when the tumor diameter was>5 cm. Conclusions The expression of IER5 protein in patients with cervical cancer is significantly higher after radiotherapy. Moreover, IER5 expression gets higher with the increase in radiation dose, indicating that IER5 is related to the radiosensitivity of patients with cervical cancer. The smaller the tumor,the more radiation dose-dependent the IER5 expression.