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  1. NTU Theses and Dissertations Repository
  2. 公共衛生學院
  3. 流行病學與預防醫學研究所
請用此 Handle URI 來引用此文件: http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/44099
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dc.contributor.advisor于明暉(Ming-Whei Yu)
dc.contributor.authorWei-Chih Liaoen
dc.contributor.author廖偉智zh_TW
dc.date.accessioned2021-06-15T02:39:53Z-
dc.date.available2012-09-16
dc.date.copyright2009-09-16
dc.date.issued2009
dc.date.submitted2009-08-12
dc.identifier.citation1. Jemal A, Siegel R, Ward E, et al: Cancer statistics, 2008. CA Cancer J Clin 58:71-96, 2008.
2. Li D, Xie K, Wolff R, et al: Pancreatic cancer. Lancet 363:1049-57, 2004.
3. Sperti C, Pasquali C, Piccoli A, et al: Recurrence after resection for ductal adenocarcinoma of the pancreas. World J Surg 21:195-200, 1997.
4. Sohn TA, Yeo CJ, Cameron JL, et al: Resected adenocarcinoma of the pancreas-616 patients: results, outcomes, and prognostic indicators. J Gastrointest Surg 4:567-79, 2000.
5. Sener SF, Fremgen A, Menck HR, et al: Pancreatic cancer: a report of treatment and survival trends for 100,313 patients diagnosed from 1985-1995, using the National Cancer Database. J Am Coll Surg 189:1-7, 1999.
6. Luster AD: Chemokines--chemotactic cytokines that mediate inflammation. N Engl J Med 338:436-45, 1998.
7. Struyf S, Proost P, Van Damme J: Regulation of the immune response by the interaction of chemokines and proteases. Adv Immunol 81:1-44, 2003.
8. Andre F, Cabioglu N, Assi H, et al: Expression of chemokine receptors predicts the site of metastatic relapse in patients with axillary node positive primary breast cancer. Ann Oncol 17:945-51, 2006.
9. Muller A, Homey B, Soto H, et al: Involvement of chemokine receptors in breast cancer metastasis. Nature 410:50-6, 2001.
10. Zlotnik A: Chemokines in neoplastic progression. Semin Cancer Biol 14:181-5, 2004.
11. Saur D, Seidler B, Schneider G, et al: CXCR4 expression increases liver and lung metastasis in a mouse model of pancreatic cancer. Gastroenterology 129:1237-50, 2005.
12. Kim J, Mori T, Chen SL, et al: Chemokine receptor CXCR4 expression in patients with melanoma and colorectal cancer liver metastases and the association with disease outcome. Ann Surg 244:113-20, 2006.
13. Kim J, Takeuchi H, Lam ST, et al: Chemokine receptor CXCR4 expression in colorectal cancer patients increases the risk for recurrence and for poor survival. J Clin Oncol 23:2744-53, 2005.
14. Phillips RJ, Burdick MD, Lutz M, et al: The stromal derived factor-1/CXCL12-CXC chemokine receptor 4 biological axis in non-small cell lung cancer metastases. Am J Respir Crit Care Med 167:1676-86, 2003.
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16. Koshiba T, Hosotani R, Miyamoto Y, et al: Expression of stromal cell-derived factor 1 and CXCR4 ligand receptor system in pancreatic cancer: a possible role for tumor progression. Clin Cancer Res 6:3530-5, 2000.
17. Marchesi F, Monti P, Leone BE, et al: Increased survival, proliferation, and migration in metastatic human pancreatic tumor cells expressing functional CXCR4. Cancer Res 64:8420-7, 2004.
18. Hermann PC, Huber SL, Herrler T, et al: Distinct populations of cancer stem cells determine tumor growth and metastatic activity in human pancreatic cancer. Cell Stem Cell 1:313-23, 2007.
19. Mori T, Doi R, Koizumi M, et al: CXCR4 antagonist inhibits stromal cell-derived factor 1-induced migration and invasion of human pancreatic cancer. Mol Cancer Ther 3:29-37, 2004.
20. Wehler T, Wolfert F, Schimanski CC, et al: Strong expression of chemokine receptor CXCR4 by pancreatic cancer correlates with advanced disease. Oncol Rep 16:1159-64, 2006.
21. Greene FL, Page DL, Fleming ID, Fritz AG, Balch CM, Haller DG, Morrow M: Exocrine pancreas, in Greene FL, Page DL, Fleming ID, Fritz AG, Balch CM, Haller DG, Morrow M (ed): AJCC Cancer Staging Manual (ed 6). New York, NY, Springer-Verlag, 2002, pp 157-64.
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dc.identifier.urihttp://tdr.lib.ntu.edu.tw/jspui/handle/123456789/44099-
dc.description.abstract背景:胰臟癌病患接受腫瘤切除手術後有60%會發生肝臟復發,其預後極差。實驗性研究顯示趨化素受器CXCR4為胰臟癌病患手術後肝臟轉移之重要因子,然而其與病患預後之關連未曾獲得證實。本研究目的在探討CXCR4之表現與胰臟癌術後無肝臟復發存活及總存活之關連。
方法:共有97位接受腫瘤切除手術之患者被納入研究。利用免疫組織染色測定CXCR4之表現,然後以Kaplan-Meier estimate及多變數proportional hazards 模型分析CXCR4表現與無肝臟復發存活及總存活之關係。
結果:腫瘤CXCR4陽性之病患其預後較CXCR4陰性者為差,其無肝臟復發存活 (中位數8.7 vs 39.7個月,p=0.004)及總存活(中位數10.2 vs 22.3個月,p<0.001)較短。CXCR4陽性之IIa期病患其總存活與IIb期者相近,較CXCR4陰性之IIa期患者顯著較短(p=0.002)。CXCR4陽性對於肝臟復發與因胰臟癌死亡之校正危險比分別為2.22(p=0.018)及1.78(p=0.041)。
結論:胰臟癌表現CXCR4為術後肝臟復發與死亡之獨立預後因子。CXCR4免疫組織染色可以提供其他已知之預後預測因子所無法提供之資訊,且可改善TNM分期對術後存活之預測。
zh_TW
dc.description.abstractABSTRACT
Purpose: Liver recurrence develops in 60% of patients who undergo resection for pancreatic cancer (PC) and predicts a dismal prognosis. Experimental evidences suggested chemokine receptor CXCR4 as the key mediator of liver metastasis in PC, but its significance has not been investigated with patient outcome. This study aimed to investigate the potential associations between CXCR4 expression and liver recurrence or overall survival after resection for PC.
Methods: Ninety-seven patients undergoing R0 resection were evaluated. CXCR4 expression was analyzed by immunohistochemistry, and its association with liver recurrence-free or overall survival was analyzed by Kaplan-Meier estimates and multivariable proportional hazards models.
Results: Patients with CXCR4-positive tumors had worse prognosis than those with CXCR4-negative tumors, with a shorter liver recurrence-free survival (median: 8.7 vs. 39.7 months; p=0.004) and overall survival (median: 10.2 vs. 22.3 months; p<0.001). Overall survival for CXCR4-positive stage IIa patients was similar to stage IIb patients and significantly shorter than CXCR4-negative stage IIa patients (p=0.002). The adjusted hazard ratio of positive CXCR4 immunostaining was 2.22 for liver recurrence (p=0.018), and 1.78 for death due to PC (p=0.041), respectively.
Conclusion: CXCR4 expression is an independent predictor of early liver recurrence and death after resection for PC. CXCR4 immunohistochemistry provides exclusive prognostic information that can not be replaced by known prognostic factors and supplements TNM stage in predicting survival.
en
dc.description.provenanceMade available in DSpace on 2021-06-15T02:39:53Z (GMT). No. of bitstreams: 1
ntu-98-R95842013-1.pdf: 408697 bytes, checksum: d02aa1c824b9e876bcd9c0d6ea488cca (MD5)
Previous issue date: 2009
en
dc.description.tableofcontents1.中文摘要 4
2. Abstract 5
3. Introduction 7
4. Materials and methods 8
5. Results 12
6. Discussion 16
7. Reference 21
8. Appendix 26
dc.language.isoen
dc.subject總存活zh_TW
dc.subjectCXCR4zh_TW
dc.subject胰臟癌zh_TW
dc.subject肝臟復發zh_TW
dc.subjectsurvivalen
dc.subjectliver recurrenceen
dc.subjectpancreatic canceren
dc.subjectCXCR4en
dc.title腫瘤CXCR4表現與胰臟癌術後存活之關係:回溯性世代研究zh_TW
dc.titleTumor Expression of CXCR4 and Survival after Resection for Pancreatic Cancer: a Retrospective Cohort Studyen
dc.typeThesis
dc.date.schoolyear97-2
dc.description.degree碩士
dc.contributor.coadvisor林肇堂(Jaw-Town Lin)
dc.contributor.oralexamcommittee吳明賢(Ming-Shiang Wu)
dc.subject.keywordCXCR4,胰臟癌,肝臟復發,總存活,zh_TW
dc.subject.keywordCXCR4,pancreatic cancer,liver recurrence,survival,en
dc.relation.page36
dc.rights.note有償授權
dc.date.accepted2009-08-12
dc.contributor.author-college公共衛生學院zh_TW
dc.contributor.author-dept流行病學研究所zh_TW
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