McCain Stephen, Trainor James, McManus Damian T, McMenamin Úna C, McQuaid Stephen, Bingham Victoria, James Jacqueline A, Salto-Tellez Manuel, Turkington Richard C, Coleman Helen G
Cancer Epidemiology Research Group, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland.
Department of Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland.
Oncotarget. 2018 Sep 28;9(76):34347-34356. doi: 10.18632/oncotarget.26151.
Vitamin D receptor (VDR) expression has been associated with survival in several cancer sites. This study aims to evaluate the association between VDR expression and prognosis in oesophageal adenocarcinoma patients.
During a median of 2.5 (maximum 9) years of follow-up, 75 patients died. In analysis adjusted for confounders, higher VDR expression was associated with an improved overall survival (HR 0.49 95% CI 0.25-0.96) and disease-specific survival (HR 0.50 95% CI 0.26-0.99), when comparing the highest with the lowest tertile of expression. These associations were strongest in sensitivity analysis restricted to junctional tumours.
This study is the first to demonstrate that patients with higher VDR expression in oesophageal adenocarcinoma have a more favourable prognosis. Further work is needed to validate these findings, and to define the role of VDR in the aetiology, progression and management of oesophageal adenocarcinoma.
Oesophageal adenocarcinoma specimens and clinical data were collected from 130 patients treated with neo-adjuvant chemotherapy prior to surgical resection at the Northern Ireland Cancer Centre between 2004 and 2012. Tissue microarrays were created and immunohistochemical staining for VDR was performed on triplicate tumour cores from each resection specimen. Cox proportional hazards models were applied to evaluate associations between VDR, according to tertiles of expression, and survival outcomes.
维生素D受体（VDR）表达已与多个癌症部位的生存率相关。本研究旨在评估食管腺癌患者中VDR表达与预后之间的关联。
在中位2.5年（最长9年）的随访期间，75例患者死亡。在对混杂因素进行校正的分析中，当比较最高表达三分位数与最低表达三分位数时，较高的VDR表达与改善的总生存期（风险比0.49，95%置信区间0.25 - 0.96）和疾病特异性生存期（风险比0.50，95%置信区间0.26 - 0.99）相关。这些关联在仅限于交界性肿瘤的敏感性分析中最为显著。
本研究首次表明，食管腺癌中VDR表达较高的患者预后更有利。需要进一步开展工作来验证这些发现，并确定VDR在食管腺癌的病因、进展和管理中的作用。
收集了2004年至2012年期间在北爱尔兰癌症中心接受手术切除前新辅助化疗的130例患者的食管腺癌标本和临床数据。制作了组织微阵列，并对每个切除标本的三个肿瘤核心进行了VDR免疫组化染色。应用Cox比例风险模型来评估根据表达三分位数划分的VDR与生存结果之间的关联。
