摘要
目的：探讨影响食管鳞癌（ESCC）淋巴结转移（LNM）的临床病理及生物学相关因素。方法：应用免疫组化S-P法检测60例食管鳞癌（LNM阳性组与阴性组各30例）标本中CyclinD1、E-cad、CD44v6蛋白表达,并对两组病例的检测结果及相关临床病理资料作对比研究。结果：比较转移组与非转移组ESCC,发现侵袭肌层与穿透肌层的癌LNM率分别是37.1%和68%,P=0.018;Ⅰ级、Ⅱ级和Ⅲ级鳞癌的LNM率分别是27.8%、45.5%和75%,P=0.013;Ⅰ、Ⅱ期与Ⅲ、Ⅳ期癌的LNM率分别是36.4%和66.7%,P=0.020;E-cad阳性与阴性癌的LNM率分别是38.5%和71.4%,P=0.028;CD44v6阳性与阴性癌的LNM率分别是65%和20%,P〈0.0001。Pearson’s相关分析显示,LNM与癌侵袭深度（rs=0.304）、肿瘤分期（rs=0.302）、CD44v6（rs=0.278）过表达呈显著正相关,P〈0.05;与癌分化程度（rs=-0.377）和E-cad（rs=-0.294）阳性表达呈显著负相关,P〈0.03。结论：癌的分化程度、侵袭深度、临床分期、CD44v6过表达和E-cad阴性表达是影响ESCCLNM的重要因素。CD44v6和E-cad的不同表达在LNM中可能起协同作用,联合检测CD44v6和E-cad的表达,可作为预测ESCC预后的参考指标。
Objective： To approach related clinicopathological and cellular molecules that influence lymph nodes metastasis （LNM） in esophageal squamous cell carcinoma（ ESCC）. Methods： Immunohisto chemistry S -P method was used to examine the expression of Cyclin D1 , E - cad and CD44v6 in the pathol ogical specimens of 60 ESCC cases （LNM positive and LNM negative in 30 cases, respectively）. Contrast study with immunohistochemistry and related clinicopathological data from LNM positive cases and LNM negative cases was performed. Resuits： Comparing LNM group with non - LNM group ESCC showed that the LNM rate in carcinomas infiltrating muscular layer and penetrating muscular layer was 37.1% and 68% respectively（ P = 0. 018） , in grade Ⅰ , grade Ⅱ and grade Ⅲ ESCC was 27.8% , 45.5% and 75% respectively （P = 0. 013） and, in Ⅰ , Ⅱ stage and Ⅲ, Ⅳ stage was36.4% and 66.7% respectively（P=0.020）. The LNM rate of E - cad positive and negative ESCC was 38.5% and 71.4% ,respectively（P = 0. 028） , and CD44v6 positive and negative ESCC was 65% and 20% respectively（P 〈 0. 0001 ）. Pearson＇s corelation analysis shows that the LNM of ESCC was significantly correlated （ P 〈 0. 05 ） to invasive depth （ r, = 0. 304 ） , TNM stage（r, = 0. 302） and CD44v6 overexpression（r, = 0. 278） of ESCC, and was negatively correlated（ P 〈 0.03, to differentiated degree （r, = -0. 377 ）and the E - cad expression（ r, = - 0. 294） of ESCC. Conclusions： Differentiated degree, invasive depth and TNM stage of ESCC and, overexpression of CD44 v6 and negtive - expression of E - cad were important factors to influence LNM. Different expression of CD44v6 gene and E - cad gene may cooperatively play a role for the LNM of ESCC. The co - examination of CD44v6 and E - cad expression in primary tumors may be useful for predicting prognosis of ESCC.
出处
《实用医学进修杂志》
2007年第3期156-161,共6页
Journal of Practical Training of Medicine
