食管癌标本中PCNA及CyclinD1蛋白表达与DNA含量同时检测的意义

Impact of synthetical assay of tumor cell proliferating marked PCNA,CyclinD1 and DNA content on prognosis of esophageal carcinoma

探讨放射治疗前后PCNA、CyclinD1蛋白表达和DNA含量分型 3项指标同时检测对食管癌预后的指导作用。方法 在本院接受术前放射治疗及根治性食管癌切除术的 47例食管癌患者中男 2 8例 ,女 19例 ;单因素生存分析采用Kaplan Meier方法并用Logrank检验 ,多因素分析用Cox逐步回归模型 ,预后指数模型对整组病例进行多因素综合分析。结果 传统预后因素 (放射治疗后病理改变、T分期、N分期 )和肿瘤细胞基因蛋白PCNA、CyclinD1、DNA含量均可作为食管癌术前放射治疗 (预后生存 )的独立预后因素 ,多因素分析显示出同样结果 ,预后指数模型更敏感地反映出不同亚组的生存情况。结论 除传统预后因素外 ,肿瘤细胞标志物PCNA、CyclinD1、DNA有可能成为评估食管癌预后的参考指标 ,预后指数与各种单因素比较能更准确地提示预后生存。

Objective To explore the prognostic value of PCNA, CyclinD1 protein expression and DNA content determination in the esophageal carcinoma biopsy or surgial specimens. Methods From November 1979 to December 1996 ,47 patients were treated with preoperative radiation followed by radical esophagectomy. All cases were confirmed pathologically to have squamous cell carcinoma .Immunohistochemical PCNA and CyclinD1 stain was performed using the conventional SP method, and the DNA content was analyzed by automatic image analysis technology (AIAT). Kaplan-Meier method was used in univariate analysis and the Logrank test to inspect into possible differences . Cox stepwise regression model and the prognosis index (PI) model were used in multivariate analysis for prognosis evaluation. Results Although the verified prognostic factors radio-pathological change ,T stage and N stage having been of predictive value,the tumor cell proliferating marked PCNA ,CyclinD1 and the DNA content were demonstrated as independent prognostic factors for preoperative radiotherapy of esophageal carcinoma as well. The PI was correlative much strongly to the patients' survival in the various subgroups.Conclusions In our opinion, the tumor cell proliferating marked PCNA,CyclinD1 and DNA content are the endpoints in predicting the prognosis of esophageal carcinoma.