Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital and Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China.
World J Gastroenterol. 2013 Apr 21;19(15):2412-8. doi: 10.3748/wjg.v19.i15.2412.
To assess the prognostic value of serum human relaxin 2 (H2 RLN) level in patients with esophageal squamous cell carcinoma (ESCC).
From October 1998 to September 2009, 146 patients with histopathologically confirmed ESCC were enrolled in this study. One hundred patients underwent en bloc esophagectomy, and 46 patients with unresectable tumors underwent palliative surgery. Five of the 146 patients died of surgical complications. Serum levels of H2 RLN were measured by enzyme linked immunosorbent assay. The relationship between serum H2 RLN level and each of the clinicopathological parameters was analyzed using the χ² test. Patients were classified into two groups according to their H2 RLN level (< 0.462 ng/mL vs ≥ 0.462 ng/mL). When any analysis cell had fewer than five cases, the Fisher's exact test was used. The statistical difference between groups A and B in each clinicopathological category was determined by the Student's t test (two-tailed) or analysis of variance. Survival curves were plotted using the Kaplan-Meier method. The statistical difference in survival between the different groups was compared using the log-rank test. Survival correlation with the prognostic factors was further investigated by multivariate analysis using the Cox proportional hazards model with backward stepwise likelihood ratio.
ESCC patients tended to have significantly higher serum H2 RLN concentrations (0.48 ± 0.17 ng/mL, n = 141) compared with the healthy control group (0.342 ± 0.12 ng/mL, n = 112). There was a significant difference between patients with lymph node involvement (0.74 ± 0.15 ng/mL, n = 90), distant metastasis (0.90 ± 0.19 ng/mL, n = 32) and those without lymph node involvement (0.45 ± 0.12 ng/mL, n = 51), and distant metastasis (0.43 ± 0.14 ng/mL, n = 109), respectively (P < 0.01). Patients with high H2 RLN levels (≥ 0.462 ng/mL) had a poorer prognosis than patients with low serum H2 RLN levels (< 0.462 ng/mL; P = 0.0056). The H2 RLN level was also correlated with survival and tumor-node-metastasis staging, but not with age, tumor size, gender, lymphovascular invasion or the histological grade of tumors. Cox regression analysis showed that H2 RLN was an independent variable.
Serum concentrations of H2 RLN are frequently elevated in ESCC patients and are correlated with disease metastasis and survival. Serum concentrations of H2 RLN may be an important prognostic marker in ESCC patients.
评估血清人松弛素 2（H2 RLN）水平在食管鳞状细胞癌（ESCC）患者中的预后价值。
本研究纳入了 1998 年 10 月至 2009 年 9 月期间经组织病理学证实的 146 例 ESCC 患者。其中 100 例患者接受了整块食管切除术，46 例不可切除肿瘤患者接受了姑息性手术。146 例患者中有 5 例死于手术并发症。采用酶联免疫吸附试验测定 H2 RLN 血清水平。采用卡方检验分析血清 H2 RLN 水平与各临床病理参数之间的关系。根据 H2 RLN 水平（<0.462ng/mL 与≥0.462ng/mL）将患者分为两组。当任何分析细胞的例数少于 5 例时，采用 Fisher 确切概率法。采用学生 t 检验（双侧）或方差分析比较 A、B 两组在各临床病理类别中的统计学差异。采用 Kaplan-Meier 法绘制生存曲线。采用对数秩检验比较不同组间的生存差异。采用 Cox 比例风险模型的逐步后向似然比法进一步分析生存与预后因素的相关性。
ESCC 患者的血清 H2 RLN 浓度（0.48±0.17ng/mL，n=141）明显高于健康对照组（0.342±0.12ng/mL，n=112），差异具有统计学意义。有淋巴结受累（0.74±0.15ng/mL，n=90）、远处转移（0.90±0.19ng/mL，n=32）患者的血清 H2 RLN 浓度明显高于无淋巴结受累（0.45±0.12ng/mL，n=51）和无远处转移（0.43±0.14ng/mL，n=109）患者，差异具有统计学意义（P<0.01）。H2 RLN 水平较高（≥0.462ng/mL）的患者预后较 H2 RLN 水平较低（<0.462ng/mL）的患者差（P=0.0056）。H2 RLN 水平与生存和肿瘤-淋巴结-转移分期相关，但与年龄、肿瘤大小、性别、血管淋巴管侵犯或肿瘤组织学分级无关。Cox 回归分析显示，H2 RLN 是独立变量。
ESCC 患者血清 H2 RLN 浓度常升高，并与疾病转移和生存相关。血清 H2 RLN 浓度可能是 ESCC 患者的一个重要预后标志物。
