Mizrak Kaya Dilsa, Dong Xiaochuan, Nogueras-González Graciela M, Xu Yan, Estrella Jeannelyn S, Harada Kazuto, Lopez Anthony, Amlashi Fatemeh G, Hofstetter Wayne L, Maru Dipen M, Nguyen Quynh-Nhu, Lee Jeffrey H, Weston Brian, Bhutani Manoop S, Erasmus Jeremy J, Thomas Irene, Rogers Jane E, Song Shumei, Ajani Jaffer A
Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX, 77030, USA.
Department of Biostatistics, The University of Texas MD Anderson Cancer, Houston, TX, USA.
Med Oncol. 2017 Aug;34(8):135. doi: 10.1007/s12032-017-0994-2. Epub 2017 Jul 6.
Resectable esophageal adenocarcinoma (EAC) patients often receive chemoradiation followed by surgery. However, most patients experience recurrences. Overexpression of MTDH, an oncoprotein with multiple functions, has been found to be associated with poor prognosis in breast cancer, glioblastoma, melanoma and various gastrointestinal malignancies, but not in EAC. We sought to establish its role in resistant EAC (post-treatment residual EAC). MTDH was assessed by immunohistochemistry in resected EAC, and results were correlated with clinical outcomes. MTDH expression was detectable in 72.5% (50/69) of patients, while expression levels were high (positive) in 50.7% (35/69). Of 69 patients analyzed, 25 had no relapse and 44 patients had a relapse (8 with local-regional and 36 with distant). The median follow-up duration was 3 years (0.4-11.6). The median overall survival was not associated with MTDH status (2.79 years for MTDH-negative and 3.60 years for MTDH-positive patients, p = 0.121). In addition, MTDH was not associated with either the type of relapse (local or distant), baseline clinical stage, tumor grade, presence of signet ring cells, surgical (yp) stage, percentage of residual EAC or presence of lymphovascular invasion. Our data reveal that MTDH is not a prognostic biomarker in resistant EAC after trimodality therapy.
可切除的食管腺癌（EAC）患者通常先接受放化疗，然后进行手术。然而，大多数患者会复发。已发现具有多种功能的癌蛋白MTDH过表达与乳腺癌、胶质母细胞瘤、黑色素瘤及各种胃肠道恶性肿瘤的不良预后相关，但在EAC中并非如此。我们试图确定其在耐药性EAC（治疗后残留EAC）中的作用。通过免疫组织化学对切除的EAC中的MTDH进行评估，并将结果与临床结局相关联。在72.5%（50/69）的患者中可检测到MTDH表达，而50.7%（35/69）的患者表达水平较高（阳性）。在分析的69例患者中，25例未复发，44例复发（8例为局部区域复发，36例为远处复发）。中位随访时间为3年（0.4 - 11.6年）。中位总生存期与MTDH状态无关（MTDH阴性患者为2.79年，MTDH阳性患者为3.60年，p = 0.121）。此外，MTDH与复发类型（局部或远处）、基线临床分期、肿瘤分级、印戒细胞的存在、手术（yp）分期、残留EAC的百分比或脉管浸润的存在均无关。我们的数据表明，MTDH不是三联疗法后耐药性EAC的预后生物标志物。
