O6-甲基鸟嘌呤-DNA甲基转移酶联合存活素对食管癌新辅助放化疗敏感性的预测效能OA

Objective To explore the predictive efficacy of O6-methylguanine-DNA methyltransferase(MGMT)combined with survivin in predicting the sensitivity of neoadjuvant chemoradiotherapy in patients with esophageal cancer.Methods A total of 154 patients with stage cⅡ-Ⅳa esophageal cancer who received neoadjuvant chemoradiotherapy and were admitted to Shaanxi Provincial People's Hospital from January 2021 to December 2023 were retrospectively enrolled,and divided into the effective group(89 cases)and the ineffective group(65 cases)according to the curative effect of chemoradiotherapy.The clinical data and the mRNA expression levels of MGMT and survivin before chemoradiotherapy were compared between the two groups.Logistic regression analysis was used to screen the influencing factors of neoadjuvant chemoradiotherapy efficacy,and ROC curve analysis was adopted to evaluate the predictive efficiency of each single index and the combined index fitted by logistic regression on the efficacy of neoadjuvant chemoradiotherapy.Results The tumor T stage,N stage,histological grade,and mRNA expression levels of MGMT and survivin in the ineffective group were significantly higher than those in the effective group(all P＜0.05).Logistic regression analysis showed that T stage,histological grade,and mRNA expression levels of MGMT and survivin were all independent influencing factors of neoadjuvant chemoradiotherapy efficacy for esophageal cancer(all P＜0.05).ROC curve analysis revealed that the AUC of T stage,histological grade,MGMT mRNA and survivin mRNA alone in predicting neoadjuvant chemoradiotherapy efficacy was 0.624,0.571,0.763 and 0.787,respectively;the AUC of combined prediction of the four indicators was 0.871,which was significantly higher than that of each single indicator,with a sensitivity of 0.800 and a specificity of 0.820.Conclusion The elevated expression of MGMT and survivin in esophageal cancer patients is closely associated with the ineffectiveness of neoadjuvant chemoradiotherapy.T stage,histological grade combined with mRNA expression levels of MGMT and survivin present favorable predictive efficacy for the efficacy of neoadjuvant chemoradiotherapy in esophageal cancer,which can provide a reference for clinical individualized treatment.