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PCNA、p53、nm23-H1蛋自表达，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；p53阳性与阴性癌的LNM率分别是68．4％和18．2％，P〈0．0001；nm23-HI阳性与阴性癌的LNM率分别是36．1％和70．8％。P〈0．001。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）、p53过表达（rs=0．456）呈显著正相关，P〈0．05；与癌分化程度（rs=-0．377）和nm23-HI（rs=-0．400）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、肿瘤分期、p53过表达和nm23-H1阴性表达是影响ESCCLNM的重要因素。p53和nm23-HI的不同表达在LNM中可能起协同作用，联合检测p53和nm23-HI的表达，可作为预测ESCC预后的参考指标。
Objective：To approach relative clinicopathological and biological factors 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 PCNA, p53 and nm23 - H1 in the pathological specimens of 60 ESCC cases （ LNM positive and LNM negative in 30 cases, respectively）. Contrast study of immunohistochemistry results and relative clinicopathological data from LNM positive cases and LNM negative cases was performed. Results：Comparing LNM group with non- LNM group ESCC show 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 stage, Ⅱ stage and Ⅲ stage, IV stage was 36.4 % and 66.7 % respectively （ P = 0. 020 ）. The LNM rate of p53 positive and negative ESCC was 68.2% and 18.2% respectively（ P 〈 0. 0001 ） , and nm23 - H1 positive and negative ESCC was 36. 1% and 70.8% respectively（ P 〈 0. 001 ）. Pearson＇ s corelation analysis shows that the LNM of ESCC was significantly correlated （ P 〈 0.05 ） to invasive depth （ rs = 0. 304 ） , tumor stage（ rs = 0. 302 ） and p53 overexpression（ rs = 0. 456 ） of ESCC, and was negatively correlated（ P 〈 0.03 ） to differentiated degree（ rs = - 0. 377 ） and the nm23 H1 expression（ rs = - 0. 400） of ESCC. Conclusions： Differentiated degree, invasive depth and tumor stage of ESCC and, overexpression of p53 and negative - negtive - expression of nm23 - H1 were important factors to influence LNM. Different expression of p53 gene and nm23 - H1 gene may coopera- tively play a role for the LNM of ESCC. The co - expressions of p53 and nm23 - H1 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1期21-26,共6页
Journal of Practical Training of Medicine
