Id-1 PTEN表达与食管鳞癌血管新生及预后关系的研究

Relationship of the Expression of Id-1 and PTEN with the Angiogenesis and Prognosis of Esophageal Squamous Cell Carcinoma

目的:研究Id-1、PTEN蛋白在食管鳞状细胞癌(ESCC)中的表达及二者在食管鳞癌血管新生及预后中的作用。方法:ESCC手术切除标本131例,癌旁正常组织40例为正常对照,免疫组化检测Id-1、PTEN表达,通过CD-34计算食管鳞癌微血管密度(MVD),分析Id-1、PTEN与MVD的关系,并通过Kaplan-Meier寿命表法及COX回归分析与预后的关系。结果:Id-1在ESCC组织中的阳性表达率83.2%(109/131),切缘正常组织中阳性率5%(2/40),二者差异有显著性(P<0.01),其表达与患者年龄、性别、浸润深度及淋巴结转移均无关(P>0.05),而与细胞分化、MVD呈正相关(P<0.01),与ESCC患者预后呈负相关。PTEN在切缘正常组织中达到97.5%(39/40),而在ESCC组织中阳性表达率为62.6%(82/131),二者差异有显著性(P<0.01),其表达与患者年龄、性别、分化程度无关,而与浸润深度、淋巴结转移及MVD呈负相关(P<0.05),而与ESCC预后呈正相关。在对血管新生的影响方面,可能Id-1起更重要作用,二者差别有统计学意义(P<0.05)。COX回归提示Id-1、PTEN表达及侵袭深度均为影响患者预后的重要因素(P<0.05)。结论:Id-1高表达或PTEN表达下调可能促进了ESCC发生、血管新生,并降低了ESCC患者的预后生存期。ESCC中Id-1、PTEN表达在血管生成方面呈拮抗关系,以Id-1作用为主,Id-1、PTEN可能是ESCC患者预后的独立影响因素。

Objective; To study the expression of Id-1 and PTEN protein in ESCC and their functions in the angiogenesis and prognosis of ESCC. Methods： We used immunohistochemistry to detect the expression of Id-1 and PTEN in 131 surgical specimens of ESCC and 40 samples of normol esophageal tissue. The relationship of Id-1 and PTEN with MVO was analyzed after assessing the microvessel density （MVD） in ESCC depending on CD-34 expression. The relationship of these indices with the prognosis was analyzed by Kaplan-Meier life table method and COX regression model. Results： The positive expression rate of Id-1 was 83.2% （109/131） in ESCC and 5% （2/40） in the incisal edge of normal tissues, with a significant difference （P〈 0.01）. The expression of Id-1 was not correlated with age, sex, infiltration degree and lymphatic metastasis （P〈0.05）. Id-1 expression was positively correlated with the degree of cancer differentiation and MVD （P〈 0.01） and was negatively correlated with the prognosis of patients. The positive expression rate of PTEN was 62.6% （82/131） in ESCC and 97.5% （39/40） in the incisal edge of normal tissues, with a significant difference （P〈0.01）. The expression of PTEN was not correlated with age, sex, and degree of cancer differentiation, but was obviously correlated with infiltration degree and lymphatic metastasis （P〈0.05）. PTEN expression was negatively correlated with MVD （P〈0.01） and was positively correlated with the prognosis of ESCC. COX regression model showed that Id-1 and PTEN expression and infiltration degree were all important factors that can predict the prognosis of ESCC. Conclusion： High expression of Id-1 or down-regulated expression of PTEN may have a a crucial effect on promoting the genesis of ESCC and its angiogenesis. Id-1 may play a more important role in the angiogenesis of ESCC. Both Id-1 and PTEN are independent factors of the prognosis of prognosis of ESCC