nm23-H1在食管鳞状细胞癌中的预后意义

Prognostic significance of nm23-H1 expression in esophageal squamous cell carcinoma.

作者信息

Wang Liang-Shun, Chow Kuan-Chih, Lien Yung-Chang, Kuo Kuang-Tai, Li Wing-Yin

机构信息

Division of Thoracic Surgery, Department of Surgery, Taipei-Veterans General Hospital and National Yang-Ming University, 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan, ROC.

出版信息

Eur J Cardiothorac Surg. 2004 Aug;26(2):419-24. doi: 10.1016/j.ejcts.2004.03.045.

DOI:10.1016/j.ejcts.2004.03.045

PMID:15296908

Abstract

OBJECTIVES

Tumor recurrence and metastasis are major causes of treatment failure in esophageal squamous cell carcinoma (ESCC). Recently, nm23, originally considered to be an anti-metastatic gene, has been reported to associate with various roles in different human cancers. We therefore investigated the clinical significance of nm23-H1 expression in ESCC.

METHODS

Pathological sections were immunohistochemically stained with monoclonal antibody that was specific to nm23-H1. Expression of positive nm23-H1 staining was further confirmed by Western blot and reverse transcription-polymerase chain reaction (RT-PCR). The relationship between nm23-H1 expression and clinicopathological variables was examined by statistical analysis. Except for 11 (7%) surgical morality, the remaining 145 patients entered the prognostic analysis. The cisplatin-based chemotherapy was established for the patients with tumor stages at or beyond IIb, or with tumor recurrence. Survival difference between groups was compared by log rank test.

RESULTS

Immunohistochemically, nm23-H1 expression was detected in 39.3% (57/145) of the pathological sections. It was positively correlated with tumor stage (P = 0.002), evident lymphovascular invasion (P < 0.001) and tumor recurrence (P = 0.02). Survival of nm23-H1 positive group was statistically superior to nm23-H1 negative group (P < 0.0001) By multivariate survival analysis, tumor stage, the number of lymph node metastasis and expression of nm23-H1 were the independent prognostic factors for ESCC patients.

CONCLUSIONS

Our study demonstrated that nm23-H1 expression was associated with disease progression in ESCC. However, survival of nm23-H1 positive group was superior to nm23-H1 negative group. This paradoxical result could suppose that nm23-H1 expression might increase cisplatin chemosensitivity and hence improve survival. Screening for nm23-H1 expression in tumor cells may be a potential therapeutic strategy in ESCC patients.

摘要

目的

肿瘤复发和转移是食管鳞状细胞癌（ESCC）治疗失败的主要原因。最近，nm23最初被认为是一种抗转移基因，据报道在不同的人类癌症中具有多种作用。因此，我们研究了nm23-H1在ESCC中的表达的临床意义。

方法

病理切片用对nm23-H1特异的单克隆抗体进行免疫组织化学染色。通过蛋白质印迹法和逆转录-聚合酶链反应（RT-PCR）进一步证实nm23-H1阳性染色的表达。通过统计分析检查nm23-H1表达与临床病理变量之间的关系。除11例（7%）手术死亡率外，其余145例患者进入预后分析。对于肿瘤分期为IIb期及以上或有肿瘤复发的患者，采用以顺铂为基础的化疗。通过对数秩检验比较组间生存差异。

结果

免疫组织化学检测显示，145例病理切片中有39.3%（57/145）检测到nm23-H1表达。它与肿瘤分期（P = 0.002）、明显的淋巴管浸润（P < 0.001）和肿瘤复发（P = 0.02）呈正相关。nm23-H1阳性组的生存率在统计学上优于nm23-H1阴性组（P < 0.0001）。通过多因素生存分析，肿瘤分期。淋巴结转移数量和nm23-H1表达是ESCC患者的独立预后因素。