上皮-间质转化相关标志物对鼻咽癌远期疗效预测的意义

摘要

Objective To investigate the expression of epithelial-mesenchymal transition ( EMT) associated markers including N-Cadherin, E-Cadherin, Vimentin and Twist in nasopharyngeal carcinoma ( NPC) and their predictive values for recurrence and metastasis. Methods E-Cadherin, N-Cadherin, Vimentin and Twist protein were detected by immunohistochemistry in 77 cases of NPC. The positive expressions were analyzed by quantitative computer-assisted image analysis system. Univariate and multivariate analysis were performed to predict the recurrence and metastasis of the disease. Results Univariate analysis showed that the expressions of E-Cadherin, N-Cadherin, Vimentin and Twist significantly correlated with NPC recurrence and metastasis ( P < 0. 05 ). Multivariate analysis demonstrated that E-Cadherin and Vimentin were independent risk factors for recurrence and metastasis of NPC. Survival analysis was made by Kaplan-meier method, and a survival curve was produced. Log-rank test showed the survival rates in the low expression group of E-Cadherin, N-Cadherin and Twist were significantly different from those in the high expression group (P < 0. 05 ) , while the difference between Vimentin low expression and high expression was not significant (P =0.055). Conclusions E-Cadherin, N-Cadherin, Vimentin and Twist significantly correlated with the recurrence and metastasis of NPC. EMT-related markers had significant predictive value for the prognosis of NPC.%目的 探讨上皮-间质转化(epithelial-mesenchymal transition,EMT)相关标志物神经钙粘连素(N-Cadherin)、上皮钙粘连素(E-Cadherin)、波形蛋白(Vimentin)和Twist在鼻咽癌肿瘤组织中的表达,及其对鼻咽癌复发、转移和预后的意义.方法 采用免疫组织化学方法检测77例鼻咽癌组织标本中的E-Cadherin、N-Cadherin、Vimentin和Twist蛋白表达.通过计算机辅助图像分析系统定量分析各EMT相关标志物的表达情况.采用单因素和多因素分析方法评估上述标志物对鼻咽癌复发、转移的预测价值.结果 单因素分析显示,E-Cadherin、N-Cadherin、Vimentin和Twist蛋白表达与鼻咽癌复发、转移相关(P＜0.05).多因素分析显示,E-Cadherin和Vimentin是影响鼻咽癌复发、转移的独立风险因素.采用Kaplan-Meier法进行生存分析并作生存曲线.Log-rank检验显示,肿瘤组织内E-Cadherin、N-Cadherin、Twist低表达与高表达患者间生存率均有显著差异(P＜0.05),而Vimentin高表达与低表达患者间生存率差异不显著(P=0.055).结论 E-Cadherin、N-Cadherin、Vimentin和Twist蛋白与鼻咽癌转移、复发密切相关.EMT相关标志物对鼻咽癌侵袭、转移和预后有一定的预测价值.