乳腺癌易感基因1在食管鳞癌中的表达及临床意义

Expression and clinical significance of BRCA1 in human esophageal squamous cell carcinoma

目的研究食管鳞癌组织中乳腺癌易感基因1（BRCA1）的表达与患者临床病理特征及预后之间的关系。方法采用免疫组织化学染色法检测201例手术切除的T3期食管鳞癌患者癌与癌旁正常组织中BRCA1蛋白的表达。采用，检验分析BRCA1蛋白的表达与患者临床病理特征间的关系，应用Kaplan—Meier法计算累积生存率，以Cox回归模型分析影响预后的因素。结果BRCA1蛋白在食管鳞癌组织中主要定位于细胞质。BRCA1蛋白在食管鳞癌组织中的阳性表达率为88．6％（178／201），明显高于癌旁正常组织[36．8％（74／201），P〈0．001]。BRCA1蛋白的表达与食管鳞癌的大体类型和淋巴结转移有关，其中淋巴结转移的食管鳞癌患者组织中BRCA1蛋白的强阳性表达率（45．0％）明显高于无淋巴结转移者（19．6％，P〈0．001）。Kaplan—Meier生存分析结果显示，BRCA1蛋白强阳性表达的食管鳞癌患者预后较差（P〈0．05）。结论BRCA1蛋白的表达与食管鳞癌的发生发展有关，有可能作为评估食管鳞癌生物学行为的、新的分子标志物。

Objective To investigate the expression of BRCA1 in esophageal squamous cell carcinoma （ESCC） tissues and evaluate its correlation with clinicopathological features as well as the prognosis of ESCC patients. Methods The expression of BRCA1 was detected by immunohistochemistry （IHC） in 201 specimens of T3 stage ESCC tissues and corresponding adjacent normal tissues using tissue microarray. The correlation between BRCA1 expression and clinicopathological features of ESCC was determined by chi-square analysis. The cumulative survival rate was analyzed by Kaplan-Meier method. Results The positive rate of BRCA1 expression in ESCC tissues was significantly higher than that in adjacent normal tissues [ 88.6% （ 178/201 ） vs. 36.8% （74/201）, P 〈 0.001 ]. There was a significant correlation between the expression of BRCA1 and lymph node metastasis. In the tumors with positive lymph nodes, strong positive expression of BRCA1 was found in 45.0% （49/109） , while only 19.6% （18/92） in tumors without lymph node metastasis, showing a significant difference （ P 〈 0. 001 ）. A close relationship was also found between the expression of BRCA1 and gross typing of tumors （P 〈 0.05）. The expression of BRCA1 was not significantly correlated with gender, age, tumor location, differentiation, and tumor thrombus （ P 〉 0.05 ）. The results of Kaplan-Meier analysis indicated that ESCC patients with a higher positive rate of BRCA1 expression have a poorer prognosis （ P 〈 0.05 ）. Conclusions The expression of BRCA1 is related to the occurrence and development of esophageal carcinoma. BRCA1 protein may serve as a new potential biomarker in estimating the biological behavior of ESCC.