上皮-间质转化相关标志物对鼻咽癌远期疗效预测的意义

Role of epithelial-mesenchymal transition related markers in predicting the long-term prognosis of nasopharyngeal carcinoma

目的探讨上皮-间质转化(epithelial-mesenchymal transition,EMT)相关标志物神经钙粘连素(N-Cadherin)、上皮钙粘连素(E-Cadherin)、波形蛋白(Vimentin)和Twist在鼻咽癌肿瘤组织中的表达,及其对鼻咽癌复发、转移和预后的意义。方法采用免疫组织化学方法检测77例鼻咽癌组织标本中的E-Cadherin、N-Cadherin、Vimentin和Twist蛋白表达。通过计算机辅助图像分析系统定量分析各EMT相关标志物的表达情况。采用单因素和多因素分析方法评估上述标志物对鼻咽癌复发、转移的预测价值。结果单因素分析显示,E-Cadherin、N-Cadherin、Vimentin和Twist蛋白表达与鼻咽癌复发、转移相关(P<0.05)。多因素分析显示,E-Cadherin和Vimentin是影响鼻咽癌复发、转移的独立风险因素。采用Kaplan-Meier法进行生存分析并作生存曲线。Log-rank检验显示,肿瘤组织内E-Cadherin、N-Cadherin、Twist低表达与高表达患者间生存率均有显著差异(P<0.05),而Vimentin高表达与低表达患者间生存率差异不显著(P=0.055)。结论 E-Cadherin、N-Cadherin、Vimentin和Twist蛋白与鼻咽癌转移、复发密切相关。EMT相关标志物对鼻咽癌侵袭、转移和预后有一定的预测价值。

Objective To investigate the expression of epithelial-mesenchymal transition （EMT） associated markers including N-Cadherin, E-Cadherin, Vimentin and Twist in nasopharyngeal carcinoma （NPC） and their predictive values for recurrence and metastasis. Methods E-Cadherin, N-Cadherin, Vimentin and Twist protein were detected by immunohistochemistry in 77 cases of NPC. The positive expressions were analyzed by quantitative computer- assisted image analysis system. Univariate and multivariate analysis were performed to predict the recurrence and metastasis of the disease. Results Univariate analysis showed that the expressions of E-Cadherin, N-Cadherin, Vimentin and Twist significantly correlated with NPC recurrence and metastasis （ P 〈 0. 05 ）. Multivariate analysis demonstrated that E-Cadherin and Vimentin were independent risk factors for recurrence and metastasis of NPC. Survival analysis was made by Kaplan-meier method, and a survival curve was produced. Log-rank test showed the survival rates in the low expression group of E-Cadherin, N-Cadherin and Twist were significantly different from those in the high expression group （P 〈 0. 05 ）, while the difference between Vimentin low expression and high expression was not significant（P =0.055）. Conclusions E-Cadherin, N-Cadherin, Vimentin and Twist significantly correlated with the recurrence and metastasis of NPC. EMT-related markers had significant predictive value for the prognosis of NPC.