Izzo Julie G, Malhotra Usha, Wu Tsung-Teh, Luthra Rajalakshmi, Correa Arlene M, Swisher Stephen G, Hofstetter Wayne, Chao K S Clifford, Hung Mien-Chie, Ajani Jaffer A
Department of Experimental Therapeutics, The Univerisity of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
Cancer Epidemiol Biomarkers Prev. 2007 Jun;16(6):1200-5. doi: 10.1158/1055-9965.EPI-06-1083.
The expression of transcriptional factor nuclear factor kappaB (NF-kappaB) in untreated esophageal cancer specimens from patients who receive preoperative chemoradiation is associated with aggressive clinical biology. We hypothesized that nuclear NF-kappaB would define clinical biology even when surgery is used as primary therapy.
Consecutive patients who did not receive any preoperative therapy were selected. Surgical cancer specimens were examined for nuclear NF-kappaB and correlated with overall survival (OS) and disease-free survival (DFS).
One hundred twenty-three patients (stage I, 9%; stage II, 24%; stage III, 53%; stage IV, 15%) with adenocarcinoma who underwent surgery as primary therapy were analyzed. Most patients were men (90%) and the median age was 63 years. For all 123 patients, the median DFS was 21 months and the median OS was 28 months. Nuclear NF-kappaB was associated with shortened DFS (P = 0.001) in 123 patients but also in stage II (P = 0.03) and stage III (P = 0.04). Nuclear NF-kappaB was associated with shortened OS (P = 0.002) in 123 patients and in stage II (P = 0.04) and showed trend in stage III (P = 0.17). Numbers are too small for stages I and IV. In multivariate models, nuclear NF-kappaB was an independent predictor for both DFS and OS (P = 0.005 and P = 0.01).
Our data are the first to show that NF-kappaB status significantly correlates with DFS and OS for patients with esophageal adenocarcinoma undergoing surgery as primary therapy. NF-kappaB is an independent prognosticator of outcome, even for individual stages (e.g., stages II and III). More comprehensive molecular studies could help the design of strategies to individualize therapy of esophageal adenocarcinoma.
在接受术前放化疗的患者未经治疗的食管癌标本中，转录因子核因子κB（NF-κB）的表达与侵袭性临床生物学行为相关。我们推测，即使手术作为主要治疗手段，细胞核NF-κB也能界定临床生物学行为。
选取未接受任何术前治疗的连续患者。对手术切除的癌组织标本检测细胞核NF-κB，并与总生存期（OS）和无病生存期（DFS）进行相关性分析。
分析了123例接受手术作为主要治疗手段的腺癌患者（I期，9%；II期，24%；III期，53%；IV期，15%）。大多数患者为男性（90%），中位年龄为63岁。123例患者的中位DFS为21个月，中位OS为28个月。细胞核NF-κB与123例患者的DFS缩短相关（P = 0.001），在II期（P = 0.03）和III期（P = 0.04）患者中也是如此。细胞核NF-κB与123例患者的OS缩短相关（P = 0.002），在II期（P = 0.04）患者中也是如此，在III期患者中呈趋势性相关（P = 0.17）。I期和IV期患者数量过少。在多变量模型中，细胞核NF-κB是DFS和OS的独立预测因素（P = 0.005和P = 0.01）。
我们的数据首次表明，NF-κB状态与接受手术作为主要治疗手段的食管腺癌患者的DFS和OS显著相关。NF-κB是结局的独立预后因素，即使对于个别分期（如II期和III期）也是如此。更全面的分子研究有助于设计食管腺癌个体化治疗策略。
