CXCR4和CCR7在Barrett's食管、食管腺癌和食管鳞癌中的表达及其临床意义

Clinical significance of CXCR4 and CCR7 expression in Barrett's esophagus,esophageal adenocarcinoma and esophageal squamous cell carcinoma

目的:探讨Barrett's食管(BE)、食管腺癌(EADC)和食管鳞癌(ESCC)中趋化因子受体4(CXCR4)和趋化因子受体7(CCR7)表达的临床意义.方法:应用免疫组织化学SP法对56例正常食管黏膜、80例BE(含22例BE伴多灶性非典型增生)、25例EADC和48例ESCC中的CXCR4和CCR7的表达进行检测,运用免疫组织化学图像分析加以定量,然后进行统计学分析.结果:CXCR4和CCR7在BE、EADC和ESCC中的表达均显著高于正常食管黏膜组织(CXCR4:78.75%,68.00%,83.33%vs39.29%;CCR7:60.00%,60.00%,58.33%vs30.36%;均P<0.01);CXCR4和CCR7的表达在BE、EADC和ESCC这3类食管病理类型中的表达无差异;CXCR4的表达在BE和ESCC中均显著高于CCR7(P<0.05,P<0.01).并且CXCR4和CCR7的表达差异与临床病理特征有一定关系;CXCR4和CCR7在BE、EADC和ESCC的表达与性别、年龄、病变发生位置均无关;CXCR4和CCR7的表达在BE无非典型增生和BE伴多灶性非典型增生这两类组织样本中无差异;CXCR4和CCR7在中-低分化EADC中的表达较高分化,以及有淋巴结转移较无淋巴结转移均显著升高(P<0.05);CXCR4和CCR7在ESCC中的表达水平在肿瘤TNM分期的Ⅲ-Ⅳ级较Ⅰ-Ⅱ级以及有淋巴结转移较无淋巴结转移均显著升高(P<0.05),中-低分化较高分化则极显著升高(P<0.01).BE无非典型增生、BE伴多灶性非典型增生和EADC组织中CXCR4的表达与CCR7的表达呈明显的正相关(r=0.456,r=0.652,r=0.490),而在ESCC中CXCR4的表达与CCR7的表达无相关性(r=0.076).结论:联合检测CXCR4和CCR7有助于更准确诊断BE、EADC和ESCC;CXCR4和CCR7高表达是EADC和ESCC具有较强浸润和转移潜能的重要标志;CXCR4和CCR7可能共同参与了从BE到EADC的发展过程.

AIM：To detect the expression of CXC chemokine receptor 4（CXCR4）and CC chemokine receptor 7（CCR7）in normal esophageal mucosa,Barrett＇ s esophagus（BE）,esophageal adenocarcinoma（EADC）,and esophageal squamous cell carci-noma（ESCC）,and to investigate their clinical significance.METHODS：The expression of CXCR4 and CCR7 in 56 normal esophageal mucosal speci-mens,80 BE specimens（including 22 cases of BE with multifocal atypical hyperplasia）,25 EADC specimens,and 48 ESCC specimens was exam-ined by immunohistochemistry.The expression levels of CXCR4 and CCR7 were then quantified and analyzed statistically.RESULTS：The positive expression rates of CXCR4 and CCR7 in BE,EADC and ESCC were significantly higher than those in normal esopha-geal mucosa（CXCR4：78.75%,68.00%,83.33%vs 39.29%;CCR7：60.00%,60.00%,58.33%vs 30.36%;all P0.01）.However,there were no significant differences in the positive expression rates of CXCR4 and CCR7 among BE,EADC and ESCC.The positive expression rates of CXCR4 were significantly higher than those of CCR7 in both BE and ESCC（P0.05 and 0.01）.CXCR4 and CCR7 expression was not associated with gen-der,age,and lesion site in BE,EADC and ESCC,but correlated with tumor differentiation and lymph node metastasis in EADC（both P0.05）and TNM stage,lymph node metastasis,and differentiation in ESCC（all P0.05）.A signifi-cant correlation was noted between CXCR4 and CCR7 expression in BE and EADC（r=0.262,0.490）,but not in ESCC（r=0.076）.CONCLUSION：Combined detection of CXCR4 and CCR7 expression may contribute to more accurate diagnosis of BE,EADC and ESCC.High expression levels of CXCR4 and CCR7 can be used as important parameters for evaluating tumor invasion and metastasis in both EADC and ESCC.