摘要
目的:探讨食管鳞癌组织中E-cadherin蛋白表达对术后预后的影响。方法:5 620例1985年至2016年间收集的食管鳞癌患者生物样本及临床病理信息均来自河南省食管癌重点开放实验室建立的50万例食管癌和贲门癌临床信息数据库,利用组织芯片和SP免疫组化法测定患者食管鳞癌组织中E-cadherin的表达。结果:男性患者中,分化程度低、淋巴结转移阳性、病理分期晚的患者E-cadherin表达强于分化程度高、淋巴结转移阴性、病理分期早者(P <0. 05)。女性患者中,淋巴结转移阳性、病理分期晚的患者E-cadherin表达强于淋巴结转移阴性、病理分期早者(P <0. 05)。Cox回归分析结果显示,E-cadherin阳性表达不是女性患者术后预后的独立影响因素(P=0. 089);但是男性患者的术后预后独立危险因素,HR(95%CI)为1. 126(1. 066~1. 189)。结论:癌组织中E-cadherin蛋白阳性表达是食管鳞癌男性患者术后预后的危险因素。
Aim: To investigate the effects of E-cadherin protein expression on survival of the patients with esophageal squamous cell carcinoma( ESCC). Methods: The biological samples and clinicopathological information of 5 620 patients with ESCC collected during 1985-2016 were derived from the clinical information database of 500 000 cases of esophageal and gastric cardia carcinoma of Henan key laboratory of esophageal cancer research. The expression of E-cadherin in ESCC tissue was determined by tissue microarray technology and SP immunohistochemical staining method. Results: The expression of E-cadherin was more in the female patients with lymph node metastasis and high pathological staging( P < 0. 05),which was higher in the male patients with low differentiation degree,lymph node metastasis and high pathological staging( P < 0. 05). The results of Cox regression showed that E-cadherin positive expression was the independent influencing factors of prognosis for the male patients( HR was 1. 126,95% CI was 1. 066-1. 189); but not for the female patients( P =0. 089). Conclusion: E-cadherin positive expression may be a risk factor for the prognosis of the male ESCC patients.
引文
[1] LAGERGREN J,SMYTH E,CUNNINGHAM D,et al. Oesophageal cancer[J]. Lancet,2017,390(10110):2383
[2]王立东,宋昕,赵学科,等.食管癌环境和遗传危险因素交互作用的分子基础和精准预防[J].中国肿瘤临床,2016,43(12):515
[3] ISHIGURO H,WAKASUGI T,TERASHITA Y,et al. Decreased expression of CDH1 or CTNNB1 affects poor prognosis of patients with esophageal cancer[J]. World J Surg Oncol,2016,14(1):240
[4] LIN Y,SHEN LY,FU H,et al. P21,COX-2,and E-cadherin are potential prognostic factors for esophageal squamous cell carcinoma[J]. Dis Esophagus,2017,30(2):1
[5]李韶华,丁广成,王立东,等.同一个体食管贲门双原发癌组织Survivin和E-cadherin的蛋白表达[J].中华肿瘤防治杂志,2009,16(10):764
[6]赵学科,周福有,张连群,等.食管癌变过程中PLCE1蛋白的表达[J].河南大学学报(医学版),2012,31(3):203
[7] WHEELOCK MJ,JOHNSON KR. Cadherins as modulators of cellula phenotype[J]. Annu Rev Cell Dev Biol,2003,19:207
[8] LIU F,GU LN,SHAN BE,et al. Biomarkerf or EMT and EMT in breast carcinoma:a review[J]. J Clin Med,2016,5,(7):65
[9] LUO KJ,HU Y,WEN J,et al. Cyclin D1,p53,E-cadherin,and VEGF discordant expression in paired regional metastatic lymph nodes of esophageal squamous cell carcinoma:a tissue array analysis[J]. J Surg Oncol,2011,104(3):236
[10]SIITONEN SM,KONONEN JT,HELIN HJ,et al. Reduced E-cadherin expression is associated with invasiveness and unfavorable prognosis in breast cancer[J]. Am J Clin Pathol,1996,105(4):394
[11]FANG WK,LIAO LD,GU W,et al. Down-regulatedγ-catenin expression is associated with tumor aggressiveness in esophageal cancer[J]. World J Gastroenterol,2014,20(19):5839
[12]SETOYAMA T,NATSUGOE S,OKUMURA H,et al. Alphacatenin is a significant prognostic factor than E-cadherin in esophageal squamous cell carcinoma[J]. J Surg Oncol,2007,95(2):148
[13]ZHANG G,ZHOU X,XUE L,et al. Accumulation of cytoplasmic beta-catenin correlates with reduced expression of E-cadherin,but not with phosphorylated Akt in esophageal squamous cell carcinoma:immunohistochemical study[J].Pathol Int,2005,55(6):310
[14]汤萨,黄佳,董金城,等.性别对高、低发区食管癌患者生存期的影响[J].肿瘤防治研究,2014,41(3):203
[15]张冬云,刘冉,库建伟,等.婚育因素对中国女性食管鳞状细胞癌患者的生存影响[J].世界华人消化杂志,2015,23(22):3517
[16]王启鸣.性激素及其受体与食管癌变的关系[D].郑州:郑州大学,2003.