食管鳞癌组织中上皮间质转化相关蛋白表达与临床病理学及预后的关系

摘要

目的：检测食管鳞状细胞癌（esophageal squamous cell carcinoma，ESCC）组织中上皮间质转化（epithe－lial-mesenchymal transition，EMT）相关蛋白的表达，研究其与临床病理因素及预后的相关性。方法：选取ESCC手术标本50例，免疫组化方法检测ESCC中EMT相关蛋白Twist1、E-cadherin、N-cadherin及Vimentin的表达，分析其与临床病理因素、增殖指标（Ki67）及预后之间的关系。结果：（1）ESCC中Twist1表达与癌增殖、浸润深度、淋巴结转移呈显著正相关（均P<0.01）；但Twist1表达与性别、年龄、肿瘤分化无相关性（均P>0.05）。（2）ESCC中Vimentin表达与癌增殖、分化、肿瘤浸润深度、淋巴结转移呈显著正相关（均P<0.05），而与性别、年龄无相关性（均P>0.05）。（3）E-cadherin、N-cadherin与临床病理因素无显著相关性（均P>0.05）。（4）ESCC中Twist1、N-cadherin及Vimentin高表达患者的预后显著差于相应低表达组（均P<0.05）；E-cadherin表达缺失的患者预后显著差于E-cadherin表达组（P<0.05）。结论：EMT在ESCC恶性演进（加深浸润、增加转移等）过程中发挥重要作用，是导致ESCC患者预后较差的重要原因之一。%Objective: To detect the expr essions of EMT related pro teins in Esophageal squamous cell carcinoma (ESCC) and to investigate their correlations with clinicopathological characteristics and prognosis. Methods: Histologic section was prepared from 50 samples of human primary ESCC. The protein levels of EMT related proteins including Twist1, E-cadherin, N-cadherin and Vimentin in ESCC were measured by immunohistochemistry. The correlations of these four proteins with clinicopathological characteristics, mark of proliferation, such as Ki67, and prognosis of ESCC patients were analyzed by statistical method. Results: (1)The expression of Twist1 in 50 samples of ESCC was positively associated with proliferation, depth of tumor invasion and lymph node metastasis (P<0.01, respectively). It was not associated with gender, age and tumor differentiation (P>0.05, respectively). (2)The expression of Vimentin in 50 samples of ESCC was positively associated with proliferation, tumor differentiation, depth of tumor invasion and lymph node metastasis (P<0.05, respectively). It was not associated with gender and age (P>0.05, respectively). (3)E-cadherin and N-cadherin were not associated with clinicopathological characteristics (P>0.05, respectively). (4)Overexpression of Twist1, N-cadherin or Vimentin in primary ESCC was associated with a shorter overall survival (P<0.05, respectively). The preserved E-cadherin group had a better overall survival (P<0.05). Conclusions:EMT process plays a critical role in ESCC progression including promoting tumor invasion and metastasis and is associated with poor survival of ESCC.