자궁경부암 환자에서 표피성장인자 수용체 및 c-erbB-2 암유전자 단백산물의 발현과 신보조 항암화학요법 반응도와의 상관관계

Abstract

Neoadjuvant chemotherapy prior to definitive radical surgery or radiotherapy may be effective in reducing tumor volume or clinical stage and may even enhance pelvic control and survival. However, there are significant limitations to the use of neoadjuvant therapy in non-responder group. They include delayed total treatment course, presence of drug resistant clones which result in accelerated tumor growth, and limited bone marrow reserve for subsequent difinitive therapy. Thus, there is a need to identify parameters providing a more precise indication of the response to neoadjuvant chemotherapy. From Jan. 1995 to Jan. 1996, neoadjuvant chemotherapy with 3 courses cisplatin and vincristine was used in 32 patients with invasive cervical cancer(FIGO stage Ib to IIIb; tumor size greater than 2 cm). Prior to chemotherapy, quantitative tissue levels of epidermal growth factor receptor(EGFR) and c-erbB-2 oncogene protein were measured by using an enzyme-linked imunosorbent assay(ELISA). Also, sera from patients were evaluated for squamous cell carcinoma(SCC) antigen by using a radioimmunoassay(RIA) and for urine polyamine by creatinine enzyme method. Tumor size was estimated before and after chemotherapy. Relations among oncopreteins, tumor markers and reductions of tumor size were evaluated. Tumor size prior to neoadjuvant chemotherapy did not show any correlation either with the concentrations of EGFR and c-erbB-2 oncoprotein or with levels of serum SCC antigen and urine polyamine. Also, reduction rate of tumor mass did not manifest correlation with EGFR, SCC antigen and urine polymine. However, reduction rate of tumor mass had an inverse linear correlation with the c-erbB-2 oncoprotein(Rs=-0.71, P<0.05).