| Project/Area Number |
17K10514
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
General surgery
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| Research Institution | The University of Tokushima |
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Principal Investigator |
TANGOKU Akira 徳島大学, 大学院医歯薬学研究部(医学域), 教授 (10197593)
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| Co-Investigator(Kenkyū-buntansha) |
吉田 卓弘 徳島大学, 病院, 講師 (00380105)
西野 豪志 徳島大学, 病院, 助教 (80645193)
井上 聖也 徳島大学, 大学院医歯薬学研究部(医学域), 助教 (50563813)
後藤 正和 徳島大学, 大学院医歯薬学研究部(医学域), 助教 (00437659)
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| Project Period (FY) |
2017-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2019: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000)
Fiscal Year 2018: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
Fiscal Year 2017: ¥2,340,000 (Direct Cost: ¥1,800,000、Indirect Cost: ¥540,000)
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| Keywords | 食道癌 / 術前化学療法 / 治療効果予測 / 予後予測 / Tissue Array |
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| Outline of Final Research Achievements |
Fifty-one ESCC patients were treated with primary chemotherapy followed by radical surgery, and twenty-three patients were treated with chemotherapy alone. Gene expression analyses were made using RT-qPCR with RNA extraction from the tissue biopsy samples before chemotherapy especially focused on PIK3CA, AKT-1, mTOR, 4E-BP1, p70S6K, PD-L1, and PD-L2. Further analyses were performed using RNA extraction from 67 ESCC patients after the chemotherapy.
Result of the expression of PIK3CA, mTOR, 4E-BP1 and p70S6K were significantly decreased after chemotherapy. AKT-1 and PD-L2 levels were increased after the primary chemotherapy compared with before chemotherapy. Multivariate analysis revealed that high PD-L1 expression was associated with the response to chemotherapy and high p70S6K expression was nominated as a prognostic factor. The present study demonstrated that PD-L1 was related to the response to chemotherapy and p70S6K was a prognostic factor in ESCC patients.
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| Academic Significance and Societal Importance of the Research Achievements |
食道扁平上皮癌(ESCC)は、本邦での死亡第7位の予後不良な癌腫である。進行ESCCに対して術前化学療法(NAC)が術後化学療法よりも予後良好であることが示された(JCOG9907)が、著効を呈する症例は限られている。切除可能例が増悪により切除不能となる場合やNAC後に根治切除を行っても、早期に再発する症例があり、NACは正しい治療選択であったかと悔やむことも少なくない。NAC前に予後やその治療効果予測を行うことができればこれらの問題を解決できると考える。そこでESCCの化学療法前後の遺伝子発現を比較することでより詳細な予後や治療効果因子を同定することができると考慮し、この研究を計画した。
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