MTA1表达与胸中段食管鳞癌预后的相关性

Investigation of the expression of MTA1 protein and its relationship to the prognosis in squamous cell carcinoma of the esophagus after esophagectomy

目的 探讨MTA1表达与胸中段食管鳞癌预后的相关性.方法 回顾2002年1月至2004年1月间,手术治疗165例胸中段食管癌病人临床资料.采用免疫组化进行肿瘤转移相关基因1（metastasis-associated gene 1,MTA1）检测,采用Kaplan-meier法进行生存分析、用Cox回归分析判定独立预后因素.结果 T2和T3病例MTA1表达率分别为13.3%和50%,两组差异有统计学意义（x2=13.2,P=0.00）.有、无淋巴结转移者MTA1表达率分别为53.4%和31.2%,两组差异有统计学意义（x2=8.2,P=0.04）.有、无MTA1蛋白表达者的5年生存率分别为18.3%和45.7%,两组差异有统计学意义（P=0.00）.T2病例中,有、无MTA1蛋白表达者5年生存率分别为25.0%和50.0%,两组差异无统计学意义（P=0.20） T3病例中,有、无MTA1蛋白表达者的5年生存率分别为15.6%和40.6%（P=0.01）,两组差异有统计学意义.pN0者中,有、无MTA1蛋白表达病例5年生存率分别为29.2%和54.7%（P=0.03）,两组差异有统计学意义 pN1者中,有、无MTA1蛋白表达者5年生存率分别为12.8%和34.1%（P=0.04）,两组差异有统计学意义.Cox回归分析结果显示,N分类和MTA1蛋白表达是独立的预后危险因素.结论 食管鳞癌不同的T、N分类中MTA1蛋白表达存在差别 MTA1蛋白过度表达者5年生存率降低 淋巴结转移和MTA1蛋白过度表达是独立的不利预后因素.

Objective To investigate the expression of MTA1 protein and its relationship to the prognosis in esophageal cancer after esophagectomy. Methods One hundred and sixty-five patients with middle third squamous cell carcinoma of the esophagus were enrolled in this study. All patients underwent operation in Provincial Hospital Affiliated to Shandong University between January 2002 and January 2004. The expression of MTA1 protein was detected by immunohistochemistry. All statistic analyses were performed with SPSS 10.0 statistical software. According to the clinicopathologic factors, the difference of MTA1 protein expression was compared by x2 test. Kaplan-meier method was performed to calculate the survival rate, Cox regression multivariate analysis was performed to determine independent prognostic factors. Results The 5-year survival rate in Ⅰ stage,Ⅱ stage and Ⅲstage was separately 100.0% 、38.3% and 22.4%, and the MTA1 protein expression rate in Ⅰ stage, Ⅱ stage and Ⅲ stage was separately 25.0% 、30.9% and 57.9%, the difference of MTA1 protein expression between Ⅱ stage and Ⅲ stage was statistically significant （ x2 = 11.6, P = 0. 00）. The MTA1 protein expression rate in T1 stage, T2 stage and T3 stage was separately 42.9% 、13.3% and 50%. MTA1 protein expression rate in T2 stage patients and T3 stage patients was separately 13.3% and 50%, the difference of MTA1 protein expression between them was statistically significant （x2 = 13.2, P =0.00）. The positive expression of MTA1 protein in patients with lymph node metastasis was significantly higher than those without metastasis （ x2 = 8.2, P = 0.04）. The 5-year survival rate in patients with MTA1 protein positive expression was significantly lower than those without MTA1 protein positive expression （P =0.00 ）, and the 5-year survival rate in T3 stage patients with MTA1 protein positive expression was significantly lower than those without MTA1 protein positive expression （ P =0.01 ）, and the 5-year survival rate in N0 stage patients with MTA1 protein positive expression was significantly lower than those without MTA1 protein positive expression （P = 0.03 ）, and the 5-year survival rate in N1 stage patients with MTA1 protein positive expression was significantly lower than those without MTA1 protein positive expression （ P =0.04）. However, the 5-year survival rate in T2 stage patients with MTA1 protein positive expression was not significantly lower than those without MTA1 protein positive expression （P =0.20）. The result of Cox analysis demonstrated that N stage and MTA1 protein positive expression were independent prognostic factors. Conclusion MTA1 protein overexpression was detected in esophageal squamous cell carcinoma and was found to be significantly associated with T stage and lymph node metastasis. The patients with MTA1 protein overexpression was significantly lower the 5-year survival rate than without MTA1 protein expression. Lymph node metastasis and MTA1 protein overexpression were independent prognostic factors.