食管鳞癌中PTEN和Caspase-3的表达及临床意义

Expression and clinical significance of PTEN and Caspase-3 in esophageal squamous cell carcinoma

目的探讨PTEN和Caspase-3在食管鳞癌中的表达及其与临床病理特征的关系。方法采用免疫组织化学方法检测64例食管鳞癌组织、16例食管癌旁组织和16例不典型增生上皮中的PTEN和Caspase-3表达水平;采用定期发信与门诊面检相结合的方法对64例食管鳞癌单纯手术患者连续跟踪随访5年以上。结果食管癌旁组、不典型增生组及食管鳞癌组中PTEN的阳性表达率逐渐降低,差异有统计学意义(P<0.01);PTEN表达与浸润深度呈负相关(r=-0.304,P<0.05),与分化程度呈正相关(r=0.539,P<0.01);PTEN阳性表达组5年生存率明显高于失表达组(P<0.01)。食管癌旁组、不典型增生组及食管鳞癌组中Caspase-3的阳性表达率先降低后明显上升,差异有统计学意义(P<0.01);Caspase-3表达与浸润深度呈负相关(r=-0.277,P<0.05)、与分化程度呈正相关(r=0.486,P<0.01);Caspase-3阳性表达组5年生存率明显高于失表达组(P<0.01)。在食管鳞癌中,PTEN与Caspase-3表达呈正相关(r=0.456,P<0.01)。结论PTEN和Caspase-3在食管鳞癌的发生、发展中起重要作用,联合检测PTEN和Caspase-3蛋白表达对食管鳞癌的早期诊断及判断预后有重要的参考价值。

Objective To study the expression of PTEN and Caspase-3 proteins in esophageal squamous cell carcinoma （ESCC） and to analyze the relationships between the expressions of the proteins and clinicopathologic factors as well as prognosis. Methods 64 cases of ESCCs, 16 cases of pericarcinoma tissues and 16 cases of dyspla- sia epithelium were immunohistochemically stained. All 64 patients who underwent surgical treatment up to January 2005 were regularly followed up through letters and check-ups. Results The positive expression rate in pericarcinoma tissues, dysplasia and ESCC were significantly down-regulated （P〈0.01）. PTEN expression was positively correlated with tumor differentiation degree （P〈0.01） and inversely with tumor infiltration depth （P〈0.01）. The 5-year overall survival rate of PTEN positive group was significantly better than PTEN negative group （P〈0.01）. The positive expression rate in pericarcinoma tissues, dysplasia and ESCC were significantly up-regulated （P〈0.01）. Caspase-3 expression was positively correlated with tumor differentiation degree （P〈0.01） but inversely with tumor infiltration depth （P〈0.05）. The 5-year overall survival rate of Caspase-3 positive group was statistically superior to Caspase-3 negative group （P〈0.01）. PTEN expression was positively correlated with Caspase-3 expression （P〈0.01）. Conclusion PTEN and Caspase-3 may play important roles in the carcinogenesis and development of ESCC. Combined detection of the expression of PTEN and Caspase-3 may provide more accurate information in early diagnosis and prognosis of ESCC.