乳腺癌抗雌激素药物耐药蛋白1在食管鳞癌血清和组织中的表达及临床意义

Clinical significance of breast cancer anti-estrogen drug resistance protein 1 expression in serum and tissues of esophageal squamous cell cancer

目的探讨乳腺癌抗雌激素药物耐药蛋白1（BCAR1）在食管鳞癌血清和组织中的表达及临床意义。方法采用酶联免疫吸附试验（ELISA）检测2010年2月至2011年1月间46例食管鳞癌患者和25例正常人血清BCAR1水平；应用组织芯片和免疫组织化学方法检测2004年2月至2006年7月问106例食管鳞癌和癌旁正常组织中BCARl表达。结果食管鳞癌组BCAR1血清水平显著高于正常对照组（P〈0．01）；晚期食管鳞癌BCARl血清水平显著高于早期食管鳞癌组和正常对照组（P〈0．01）；切除肿瘤后，血清BCARl水平有逐渐下降趋势。BCAR1蛋白在食管鳞癌组织中阳性率为97％（103／106），癌旁正常食管组织中有16例弱阳性，阳性率为15％（16／106），两者差异有统计学意义（P〈0．01）；BCAR1阳性表达与食管鳞癌的分化明显相关（P〈0．05），与年龄、性别、淋巴结转移、浸润深度和TNM分期明显无关（P〉0．05）。生存分析提示BCARl高表达组生存时间少于低表达组（P〈0．01）；经COX模型多因素生存分析，显示BCARl表达和淋巴结转移为独立预后因素。结论食管鳞癌血清和组织中BCARl水平显著高于正常对照组，并与疾病进展、治疗效果、分化程度和预后相关，可作为食管鳞癌诊断和判断预后重要新的肿瘤分子标记。

Objective To determine clinical significance of breast cancer anti-estrogen drug resist- ance protein 1 （BCAR1） expression in sera and tissues of esophageal squamous cell cancer （ESCC）. Methods Between Feb. 2010 and Jan. 2011, serum BCAR1 levels in 46 cases of ESCC and 25 healthy volunteers from our department were detected by using enzyme linked immunosorbent assay （ELISA）. A total of 106 ESCC samples and their adjacent normal tissues from our department obtained between Feb. 2004 and July 2006 were investigated for BCAR1 protein expression by using tissue microassay （TMA） and immunohistoehemistry （IHC）. Results The serum BCAR1 levels were significantly higher in ESCC group than in normal control group （P 〈0. 01 ）. The serum BCAR1 levels in advanced ESCC group were signifi- cantly higher than in early ESCC group and normal control group （P 〈 0. 01 ）. The serum BCARl levels were decreased after removal of ESCC. BCAR1 protein was strongly expressed in 97% of ESCC samples （103/106） , while weekly expressed in 15% of adjacent normal tissues （16/106） （P 〈 0. 001 ）. There was a significant correlation between BCAR1 positive expression and differentiation （P 〈0. 05） , however, there was no correlation between BCAR1 positive expression and age, gender, lymph node metastasis, depth of invasion and TNM stage （ P 〉 0. 05 ）. Survival analysis revealed that BCAR1 low expression was in favor of survival time in comparison with BCAR1 high expression （P 〈 0. 01 ）. BCAR1 expression and lymph node metastasis were independent prognosis indictor by COX regression analysis. Conclusion BCAR1 protein expression is significantly higher in sera and tissues of ESCC than normal control group, and has a correlation with progression, therapeutic efficacy, differentiation and prognosis of ESCC. BCARI protein might be used as a new tumor marker for diagnosis and prognosis of ESCC.