Takeno Shinsuke, Noguchi Tsuyoshi, Takahashi Yoshiaki, Fumoto Shoichi, Shibata Tomotaka, Kawahara Katsunobu
Department of Oncological Science (Surgery II), Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Yufu-City, Oita 879-5593, Japan.
Ann Surg Oncol. 2007 Apr;14(4):1431-8. doi: 10.1245/s10434-006-9286-3. Epub 2007 Jan 28.
The aim of this study was to assess the clinical outcome in patients with esophageal squamous cell carcinoma (ESCC) by using molecular biological classification based on immunohistochemical analysis in addition to tumor, node, metastasis system (TNM) classification.
Samples from 71 patients with ESCC who underwent surgery were analyzed immunohistochemically. Cyclin B1, E-cadherin, Bag-1, and heat-shock protein 70 were selected as the molecular biological parameters. The utility of molecular biological classification on clinical impact was examined and compared with TNM classification.
Three patients were diagnosed as stage 0, 14 as stage I, 20 as stage II, 19 as stage III, and 15 as stage IV by TNM classification. Thirteen patients were classified as stage 0, 17 as stage I, 21 as stage II, 18 as stage III, and 2 as stage IV by molecular biological classification. Molecular biological stage (P < .0001) and TNM stage (P < .0001) were statistically significant prognostic parameters in univariate analysis. Twenty (28.2%) of 71 patients were assigned to the same stage by both classifications, and a significant correlation was identified between the two classifications (P = .0002). Molecular biological classification (P < .01) and TNM classification (P < .0001) were independent prognostic parameters in multivariate analysis. Combined TNM and molecular biological classification accurately reflected clinical outcome (P < .0001).
Molecular biological classification combined with TNM classification is useful for assessing the prognosis of patients with ESCC.
本研究的目的是除了采用肿瘤、淋巴结、转移系统（TNM）分类外，通过基于免疫组织化学分析的分子生物学分类来评估食管鳞状细胞癌（ESCC）患者的临床结局。
对71例行手术治疗的ESCC患者的样本进行免疫组织化学分析。选择细胞周期蛋白B1、E-钙黏蛋白、Bag-1和热休克蛋白70作为分子生物学参数。检验分子生物学分类对临床影响的效用，并与TNM分类进行比较。
根据TNM分类，3例患者被诊断为0期，14例为I期，20例为II期，19例为III期，15例为IV期。根据分子生物学分类，13例患者被分类为0期，17例为I期，21例为II期，18例为III期，2例为IV期。在单因素分析中，分子生物学分期（P <.0001）和TNM分期（P <.0001）是具有统计学意义的预后参数。71例患者中有20例（28.2%）在两种分类中被归为同一期，两种分类之间存在显著相关性（P =.0002）。在多因素分析中，分子生物学分类（P <.01）和TNM分类（P <.0001）是独立的预后参数。联合TNM和分子生物学分类能准确反映临床结局（P <.0001）。
分子生物学分类与TNM分类相结合有助于评估ESCC患者的预后。
