周期素D1蛋白表达对食管癌预后的影响

Effect of cyclin D1 protein expression on the prognosis of esophageal squamous cell carcinoma treated with preoperative radiotherapy

目的探讨食管癌周期素Ｄ１（ｃｙｃｌｉｎＤ１）蛋白表达对预后的影响，评估食管癌治疗后的生存情况。方法１９７９年１１月至１９９６年１２月，１６４例食管癌患者在我院接受术前放疗及根治性食管癌切除术。放疗前活检标本和放疗后手术标本均经病理证实为鳞状细胞癌。采用前后两野垂直照射，肿瘤剂量３０～４０Ｇｙ，１５～２０次／３～４周。常规免疫组化ＳＰ方法检测ｃｙｃｌｉｎＤ１蛋白表达。结果食管鳞癌放疗前、后标本的ｃｙｃｌｉｎＤ１蛋白表达阳性率分别为６２．５％（６５／１０４）和６０．８％（９３／１５３），且放疗不能改变ｃｙｃｌｉｎＤ１蛋白表达水平。放疗后标本ｃｙｃｌｉｎＤ１蛋白表达程度不同，其生存率亦不同（Ｐ＝０．０５５）；表达者与不表达者比较，生存率差异有显著性（Ｐ＝０．０２）。尤其对无淋巴结转移者，放疗前、后ｃｙｃｌｉｎＤ１蛋白的表达，均能明显地预示生存情况。结论ｃｙｃｌｉｎＤ１蛋白表达可以预测食管癌的预后，放疗对其表达无明显影响，有可能作为食管癌临床分期的参考指标。

Objective To study the effect of cyclin D1 protein expression on the prognosis of esophageal carcinoma treated with preoperative radiotherapy. Methods From Nov.1979 to Dec.1996,164 patients were treated with preoperative radiation followed by radical esophagectomy in our hospital.All cases were confirmed by pathology as squamous cell carcinoma. Two vertical radiation fields were used to deliver a total tumor dose of 30～40Gy, with 15～20 fractions in 3～4 weeks. Immunohistochemical staining of cyclin D1 was performed using a streptavidin biotin staining technique. Results Cyclin D1 protein expression was positive in 62.5%(65/104) and 60.8%(93/153) for pre and post radiation tumor specimens ,respectively.The expression level did not change following radiation. Post radiation cyclin D1 expression influenced the survival ( P =0.055),and the survival rate differed significantly between patients who expressed cyclin D1 and those who did not ( P =0.02). Conclusion Cyclin D1 expression is of prognostic value for esophageal carcinoma. It may provide a reference criterion for the clinical staging of esophageal cancer.