Division of Thoracic Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
Ann Surg Oncol. 2012 Jul;19 Suppl 3:S549-57. doi: 10.1245/s10434-011-2043-2. Epub 2011 Sep 1.
Esophageal squamous cell carcinoma (ESCC) is a lethal malignancy, but only limited molecular markers can predict its prognosis. Recently, a DNA double-strand break repair protein Nijmegen breakage syndrome 1 (NBS1) was reported to induce Snail expression and predict poor prognosis in head and neck cancers. However, the clinicopathologic roles of NBS1 and Snail in ESCC remain unclear.
From January 1995 to September 1999, tissue samples from 153 patients with ESCC who underwent esophagectomies at our institutions were collected and made into tissue core arrays for study. Expression of NBS1 and Snail was examined by immunohistochemical staining. The clinicopathologic data were analyzed, and some additional studies were performed to explore the relationship between NBS1 and Snail.
NBS1 overexpression was observed in 28.1% (43/153) of ESCC, whereas Snail overexpression was observed in 26.1% (40/153) of ESCC. Overexpression of NBS1 correlated inversely with nodal status (P = 0.009) and was associated with better overall survival (P = 0.002). On the other hand, overexpression of Snail correlated positively with lymphovascular invasion (P = 0.034) and was associated with worse overall survival (P = 0.036). Meanwhile, NBS1 overexpression correlated inversely with Snail overexpression marginally (P = 0.084). Using the Cox regression analysis, T status (P = 0.006), M status (P = 0.008), and NBS1 overexpression (P = 0.007) were the independent factors of overall survival.
Our results showed that NBS1 overexpression was an independent factor of better survival and Snail overexpression predicted a worse survival in ESCC. Combination of NBS1 plus Snail expression status could be used as a predictor of prognosis in ESCC.
食管鳞状细胞癌（ESCC）是一种致命的恶性肿瘤，但目前仅有有限的分子标志物可以预测其预后。最近，有研究报道 DNA 双链断裂修复蛋白 Nijmegen 断裂综合征 1（NBS1）可诱导 Snail 的表达，并预测头颈部癌症的不良预后。然而，NBS1 和 Snail 在 ESCC 中的临床病理作用尚不清楚。
本研究收集了 1995 年 1 月至 1999 年 9 月期间在我院接受食管切除术的 153 例 ESCC 患者的组织样本，并制作成组织芯阵列进行研究。采用免疫组织化学染色检测 NBS1 和 Snail 的表达。分析临床病理数据，并进行了一些额外的研究以探讨 NBS1 与 Snail 之间的关系。
在 153 例 ESCC 中，有 28.1%（43/153）存在 NBS1 过表达，26.1%（40/153）存在 Snail 过表达。NBS1 过表达与淋巴结状态呈负相关（P = 0.009），与总生存率提高相关（P = 0.002）。另一方面，Snail 过表达与淋巴血管侵犯呈正相关（P = 0.034），与总生存率降低相关（P = 0.036）。同时，NBS1 过表达与 Snail 过表达呈轻度负相关（P = 0.084）。通过 Cox 回归分析，T 分期（P = 0.006）、M 分期（P = 0.008）和 NBS1 过表达（P = 0.007）是总生存率的独立因素。
我们的研究结果表明，NBS1 过表达是 ESCC 患者生存的独立预后因素，Snail 过表达预示着 ESCC 患者的生存预后较差。NBS1 与 Snail 表达状态的联合可作为 ESCC 预后的预测指标。
