趋化因子受体CCR7表达与胸中段食管癌淋巴结转移及预后的关系

Expression of CCR7 in squamous cell carcinoma of the esophagus after esophagectomy： correlation with lymph node metastasis and prognosis

目的探讨趋化因子受体CCR7表达与胸中段食管鳞癌淋巴结转移及预后的相关性。方法回顾2003年6月至2005年6月手术治疗184例胸中段食管癌病例临床资料。采用免疫组化进行趋化因子受体CCR7检测，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CCR7表达率Ⅱ期和Ⅲ期病例分别为70．3％和85．5％（χ^2=5．0，P=0．02）；T2和T3病例分别为64．9％和80．9％（χ^2=5．4，P=0．01）；有、无淋巴结转移病例分别为86．4％和65．0％（χ^2=10．8，P=0．00）两组差异均有统计学意义。有、无CCR7表达病例的5年生存率为26．3％和66．0％，差异有统计学意义（χ^2=23．7，P=0．00）；其中1、2病例分别为35．1％和70．0％（P=0．01）；T3病例分别为22．4％和60．9％（P=0．00）；pN0分别为28．8％和66．7％（P=0．00）；pN1分别为14．3％和63．6％（P=0．00），两组差异亦均有统计学意义。Cox回归分析结果显示，T分类、N分类和CCR7表达是预后独立的危险因素。结论食管鳞癌不同的T、N分类中CCR7表达存在差别；CCR7表达者5年生存率降低；肿瘤的T分类、淋巴结转移和CCR7表达是独立的不利预后因素。

Objective To investigate the expression of chemokine receptor CCR7 and its correlation with lymph node metastasis and prognosis in esophageal cancer after esophagectomy. Methods One hundred and eighty-four 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 June, 2003 and June, 2005. The expression of CCR7 was detected by immunohistochemistry. All statistic analyses were performed with SPSS 13.0 statistical software. According to the clinico-pathologic factors, the difference of CCR7 expression was compared by χ^2 test. Kaplan-meier method was performed to calculate the survival rate, Cox regression multivariate analysis was performed to determine independent prognostic factors. Results The expression rate of CCR7 in stage Ⅰ , stage Ⅱ and stage Ⅲ patients was 25.0 %, 70.3% and 85.5%, respectively. The difference of CCR7 expression between stage Ⅱand stage Ⅲ was statistically significant （χ^2 = 5.0, P = 0.02）. The CCR7 expression rate in T1, T2 and T3 patients was 33.3%, 64.9% and 80.9%, respectively. The difference of CCR7 expression between T2 and T3 was statistically significant （χ^2 = 5.4, P = 0.01 ）. The level of expression of CCR7 in patients with lymph node metastasis was significantly higher than those without metastasis （χ^2 = 10.8, P =0.00）. The 5-year survival rate instage I , stage Ⅱ and stage Ⅲ patients was 100.0%, 38.3% and 22.4%, respectively. The 5-year survival rate in patients with CCR7 overexpression was significantly lower than those without CCR7 overexpression （χ^2 = 23.7, P = 0.00）. The 5-year survival rate in T2, T3, NO and N1 patients with CCR7 overexpression was si sigificantly lower than those without CCR7 overexpression The result of Cox analysis demonstrated that T , N and CCR7 overexpression were independent prognostic factors. Conclusion CCR7 expression was detected in esophageal squamous cell carcinoma and was found to be significantly associated with T stage, N stage and lymph node metastasis. The patients with CCR7 expression was significantly lower the 5-year survival rate than without CCR7 expression. T stage, lymph node metastasis and CCR7 expression were independent prognostic factors.