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术前血清胆红素是可切除食管鳞癌的独立预后因素。

Preoperative serum bilirubin is an independent prognostic factor for curatively resected esophageal squamous cell carcinoma.

机构信息

Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, 310022, Zhejiang, China.

Zhejiang Key Laboratory of Diagnosis & Treatment Technology on Thoracic Oncology (Lung and Esophagus), Hangzhou, 310022, Zhejiang, China.

出版信息

BMC Cancer. 2023 Jul 28;23(1):706. doi: 10.1186/s12885-023-11215-4.

Abstract

PURPOSE

This study examines prognostic value of preoperative serum bilirubin, including unconjugated bilirubin (UCB), conjugated bilirubin (CB), and total bilirubin (TB), in esophageal squamous cell carcinoma (ESCC) patients who underwent curative resection.

METHODS

Between May 2010 and December 2012, a total of 351 ESCC patients were retrospectively reviewed. All the patients underwent curative resection as their primary treatment. Clinicopathological features and overall survival (OS) rate were investigated. Kaplan-Meier curves were used to calculate the OS rate, and the prognostic factors were identified by Cox regression model. Besides, the potential inhibition effect of UCB on ESCC was investigated with both in vitro and in vivo models.

RESULTS

The higher-level groups of UCB, CB, and TB demonstrated longer OS than their low counterparts, with hazard ratio (HR) values of 0.567 (95% CI: 0.424-0.759), 0.698 (95% CI: 0.522-0.933), and 0.602 (95% CI: 0.449-0.807), respectively. All three forms of bilirubin were identified as independent prognostic factors for patients with ESCC, and they were found to effectively stratify the survival risk of patients at TNM stage III. In vivo and in vitro models further confirmed the inhibitory effect of unconjugated bilirubin (UCB) on the proliferation of ESCC.

CONCLUSION

The findings of our study have shed new light on the prognostic value and biological functions of bilirubin in relation to ESCC. These results may contribute to a better understanding of the underlying mechanisms involved in ESCC tumorigenesis and provide potential therapeutic pathways for treating ESCC.

摘要

目的

本研究旨在探讨术前血清胆红素(包括未结合胆红素[UCB]、结合胆红素[CB]和总胆红素[TB])对接受根治性切除术的食管鳞状细胞癌(ESCC)患者的预后价值。

方法

回顾性分析 2010 年 5 月至 2012 年 12 月期间 351 例 ESCC 患者的临床病理特征和总生存(OS)率。所有患者均接受根治性切除术作为主要治疗方法。采用 Kaplan-Meier 曲线计算 OS 率,采用 Cox 回归模型确定预后因素。此外,还通过体外和体内模型研究了 UCB 对 ESCC 的潜在抑制作用。

结果

UCB、CB 和 TB 的高水平组比低水平组具有更长的 OS,风险比(HR)值分别为 0.567(95%CI:0.424-0.759)、0.698(95%CI:0.522-0.933)和 0.602(95%CI:0.449-0.807)。三种形式的胆红素均被确定为 ESCC 患者的独立预后因素,且可有效分层 III 期 TNM 患者的生存风险。体内和体外模型进一步证实了未结合胆红素(UCB)对 ESCC 增殖的抑制作用。

结论

本研究结果为胆红素与 ESCC 相关的预后价值和生物学功能提供了新的认识。这些结果可能有助于更好地理解 ESCC 肿瘤发生的潜在机制,并为治疗 ESCC 提供潜在的治疗途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/737e/10375695/83980b6f7dcd/12885_2023_11215_Fig1_HTML.jpg

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