Hardwick R H, Barham C P, Ozua P, Newcomb P V, Savage P, Powell R, Rahamin J, Alderson D
University Department of Surgery, Bristol Royal Infirmary, UK.
Eur J Surg Oncol. 1997 Feb;23(1):30-5. doi: 10.1016/s0748-7983(97)80139-4.
TNM staging of oesophageal cancer provides significant prognostic information but its clinical impact is limited as many patients present with advanced disease (i.e. T3N1). Additional prognostic markers may help separate those with 'good' and 'bad' prognosis tumours and so help with decisions such as selection for adjuvant therapy. p53 and c-erbB-2 overexpression may correlate with poor prognosis in oesophageal cancer, but this is uncertain. This study aimed to investigate the value of these biomarkers as prognostic indicators in resected oesophageal cancer. Two hundred and five oesophageal tumours (127 adenocarcinoma, 78 squamous) resected by a single surgeon between June 1979 and January 1991 were investigated for p53 and c-erbB-2 overexpression using DO-7 and CB-11 immunohistochemistry. Patient survival was analysed by Kaplan-Meir life tables. Median survival was 61 weeks (range: 5-747) and survival diminished significantly with increasing UICC stage (P < 0.0001). Sixty-eight per cent of squamous tumours and 66% of adenocarcinomas overexpressed p53 but there was no statistically significant correlation with prognosis. Twenty-six per cent of squamous tumours and 23% of adenocarcinomas overexpressed c-erbB-2, but again this did not correlate with survival. p53 and c-erbB-2 are commonly overexpressed in oesophageal cancer but do not appear to be related to prognosis in this large series of resected oesophageal cancers and other candidate biomarkers must be sought.
食管癌的TNM分期可提供重要的预后信息，但其临床影响有限，因为许多患者就诊时已处于疾病晚期（即T3N1）。额外的预后标志物可能有助于区分预后“良好”和“不良”的肿瘤，从而有助于做出诸如辅助治疗选择等决策。p53和c-erbB-2过表达可能与食管癌的不良预后相关，但这并不确定。本研究旨在探讨这些生物标志物作为手术切除食管癌预后指标的价值。对1979年6月至1991年1月间由同一外科医生切除的205例食管肿瘤（127例腺癌，78例鳞癌）进行研究，采用DO-7和CB-11免疫组化法检测p53和c-erbB-2过表达情况。采用Kaplan-Meir生存表分析患者生存率。中位生存期为61周（范围：5 - 747周），随着UICC分期增加，生存率显著降低（P < 0.0001）。68%的鳞癌和66%的腺癌p53过表达，但与预后无统计学显著相关性。26%的鳞癌和23%的腺癌c-erbB-2过表达，但同样与生存率无关。p53和c-erbB-2在食管癌中普遍过表达，但在这一大系列手术切除的食管癌中似乎与预后无关，必须寻找其他候选生物标志物。
