食管鳞状上皮细胞癌细胞凋亡表达及其临床意义

Clinical Significance of the Expression of Apoptosis in Esophageal Squamous Cell Carcinoma

目的探讨食管鳞状上皮细胞癌（食管鳞癌）中细胞凋亡的表达及其临床意义。方法应用末端脱氧核苷酸转移酶介导的ｄＵＴＰ缺口末端标记（ＴＵＮＥＬ）法，研究人食管鳞癌细胞凋亡的表达水平。结果３８例手术切除的食管鳞癌组织平均细胞凋亡指数ＡｐｏＬＩ为１２．１０±５．１３‰。角化型ＡｐｏＬＩ高于非角化型（Ｐ＜０．０１）；肿瘤分化越好，细胞凋亡越多，低度、中度、高度分化ＡｐｏＬＩ有差异（Ｐ＜０．０５）；不同性别、年龄、肿瘤部位、长度、深度，其ＡｐｏＬＩ并无差异；以１０‰为界将ＡｐｏＬＩ分组绘制Ｋａｐｌａｎ－Ｍｅｉｅｒ生存曲线，ＡｐｏＬＩ≥１０‰组术后生存率高。结论细胞凋亡与原发食管鳞癌临床病理特征密切相关，并可用于食管鳞癌预后判断。

Objective To determine the clinical significance of the expression of apoptosis in esophageal squamous cell carcinoma. Methods Expressional level of apoptotic cell was detected in 38 operated esophageal squamous cell carcinoma(ESCC) by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) method. Results The mean apoptotic labeling index (ApoL I:‰ of TUNEL positive cells in carcinomatous cells) was 1210±513. Mean ApoL I of keratinizing types(1577±434) was significantly higher than those of nonkeratinizing types (803±170). The ApoL I increased from 651±058 with poorly differentiated cancers through 1058±290 with moderately differentiated cancers to 1841±449 with well differentiated cancers. There was no apparent correlation between ApoL I and sex, age, tumor size, tumor location and tumor infiltrative depth. The KaplanMeier survival curves between ApoL I<10‰ and ApoL I≥10‰ have significant difference, while the former has a shorter survival time. Conclusion The results suggest that apoptosis play an important role in progression of ESCC, and apoptosis may be a prognostic marker for ESCC therapy.