BJC：HIF-1α預(yù)測(cè)膀胱癌受益于放療-CON聯(lián)合治療

　　
　　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(cè)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.

　　膀胱癌如何治療？膀胱癌的治療藥物可以選擇：復(fù)方皂礬丸、艾諾克、西黃膠囊等藥物進(jìn)行輔助治療。

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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)。