Histopathologic Effects of Neoadjuvant Therapy for Esophageal Cancer and p53 status

Research Project

Project/Area Number	11671296
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Single-year Grants
Section	一般
Research Field	Digestive surgery
Research Institution	JUNTENDO UNIVERSITY
Principal Investigator	KAJIYAMA Yoshiaki Juntendo Univ. , Associate Professor, 医学部, 講師 (70241239)
Co-Investigator(Kenkyū-buntansha)	TSURUMARU Masahiko Juntendo Univ. , Professor, 医学部, 教授 (70155448) KANNO Hitoshi Nihon Univ. Associate Professor, 医学部, 講師 (70221207)
Project Period (FY)	1999 – 2000
Project Status	Completed (Fiscal Year 2000)
Budget Amount *help	¥3,500,000 (Direct Cost: ¥3,500,000) Fiscal Year 2000: ¥1,500,000 (Direct Cost: ¥1,500,000) Fiscal Year 1999: ¥2,000,000 (Direct Cost: ¥2,000,000)
Keywords	esophageal canoer / p53 gene / histopathologic effects / neoadjuvant therapy / treatment sensitivity / immunohistochemical staining / direct sequencing / logistic regression / 化学放射線療法 / 化学療法 / 放射線療法 / 感受性 / 術前治療
Research Abstract	1. In the chemoradiotherapy group, the pathologic response rate was 86.4%, and was significantly higher than that for chemotherapy (p<0.0001), or for radiotherapy (p=0.0031). 2. In patients with normal p53 protein expression, the histopathologic response rate to chemotherapy was 20.0%, a significantly higher rate than that for patients with abnormal p53 overexpression. In the chemoradiotherapy or radiotherapy group, however, the histopathologic response rates were almost the same irrespective of p53 oncoprotein status. 3. From multivariate analysis, the neoadjuvant treatment modality was identified as the most powerful predictive factor for the histopathologic effect of neoadjuvant treatment (p=0.0002). Other identified predictive factors were the absence of "blood vessel invasion" and "intramural metastasis". 4. Direct sequencing of genomic DNA of esophageal cancer did not always coincide with the results of immunohistochemical staining of p53 protein.