ERCC1、ERCC2与食管癌临床病理特征和预后关系的研究

Correlation between ERCC1,ERCC2 expression and clinicopathological characters and prognosis in esophageal cancer

目的通过检测食管癌组织ERCC1、ERCC2蛋白的表达,探讨其与临床病理特征和预后的关系。方法随机抽取河北医科大学第四医院2001年1月1日至2001年12月31日间手术切除的食管癌患者137例,剔除双重癌、曾接受放疗、应用非铂类术前化疗患者共29例,入组病例为108例,对其进行临床病理资料登记并随访至2006年12月31日。共随访97例并建立患者临床资料Excel数据库。选取可随访97例食管癌患者纳入病例组分析,同时选取50例正常食管黏膜组织作为对照组。采用免疫组织化学SP法检测ERCC1、ERCC2在食管癌和正常黏膜组织中的蛋白水平表达,分析ERCC1和ERCC2表达与食管癌临床病理特征的相关性及与预后的关系。结果食管癌组织ERCC1、ERCC2表达阳性率分别为38.1%(37/97)、24.7%(24/97),正常食管黏膜组织中表达阳性率分别为52.0%(26/50)、42.0%(21/50)。ERCC1在正常黏膜组织中表达高于癌组织(P>0.05),ERCC2在正常黏膜组织中表达亦高于癌组织(P<0.05)。ERCC1、ERCC2表达与食管癌组织分化程度呈正相关,与性别、年龄、部位、肿瘤长度、浸润深度、病理类型、淋巴结转移以及TNM分期无相关性。ERCC1阳性表达的食管癌患者5年生存率为51.35%(19/37),ERCC1阴性表达的5年生存率26.67%(16/60),经Kaplan-Meier分析,两组差异有统计学意义(P<0.05)。ERCC2阳性表达的食管癌患者5年生存率为50.00%(12/24),ERCC2阴性表达的5年生存率31.51%(23/73),经Kaplan-Meier分析,两组差异接近统计学意义(P=0.070)。结论 ERCC1、ERCC2在正常食管黏膜组织中的表达均高于食管癌组织,且均与分化程度呈正相关。ERCC1阳性表达者预后优于阴性者,ERCC2阳性表达组则显示预后优于阴性表达组的趋势。

Objective Investigated the expression of ERCC1, ERCC2 in human esophageal cancer by immunohistochemical staining, analyzed the correlation with the clinicopathological features, and the impact on prognosis in order to evaluate the feasibility as prognosis marker of esophageal cancer. Methods To select 97 esophageal cancer patients gained complete follow-up data and 50 health esophageal and gastric cardiac tissue as control. To detect the expression of ERCC1, ERCC2 in esophageal cancer and normal tissue by S-P immunohistochemistry, and analyze the correlation of ERCC1, ERCC2 with elinicopatbologic features and prognosis of esophageal cancer. Results The positive expression of ERCC1 and ERCC2 in esophageal cancer were 38. 1% and 24. 7%, respectively. ERCC1 expression in cancer was higher than that in normal tissue, but there wasn＇t significant statistical difference between them （P 〉0. 05）, and ERCC2 expression in cancer was significantly higher than that in normal tissue （P 〈0.05 ）. Both ERCC1 and ERCC2 expression were significantly higher in well-differentiated cancer than those in moderately differentiated cancer and poor differentiation cancer （P 〈 0. 05）. Neither ERCC1 nor ERCC2 expression was correlated with sex, age, tumor location, length, depth, pathology type, lymph node metastasis or clinical stage. 5-year survival rate of ERCCl-positive patients was 51.35%, which was higher than ERCCl-negative patients （26.67%）. There was significant statistical difference between each other （P 〈 0.05 ）. 5-year survival rate of ERCC2-positive patients was 50. 00% , which was higher than ERCC2-negative patients （31.51%）. There was not significant statistical difference between each other, but it was seemed that ERCC2-positive patients had a better survival than ERCC2-negative patients （P = 0. 070）. Conclusion ERCC1, ERCC2 were examined expression on different degree either in esophageal cancer or in normal tissue. There were positive correlation between the both ERCC1 and ERCC2 expression and differentiation degree of esophageal and gastric cardiac cancer. As the differentiation degree grew better, the positive rate became higher. ERCC1 and/or ERCC2-positive expression patients had better prognosis than co-negative expression patients.