上皮钙黏蛋白表达与喉癌淋巴结转移和预后的关系

Relationship between E-cadherin expression and lymph node metastasis, prognosis in laryngeal squamous cell carcinoma

目的检测上皮钙黏蛋白(E-cadherin)在喉癌组织中的表达及其与喉癌临床病理特征、预后的关系,探讨其在喉癌发生、发展中的作用及临床应用价值。方法采用免疫组化方法检测64例喉癌组织和30例癌旁非肿瘤组织中E-cadherin蛋白表达水平,分析E-cadherin表达与喉癌临床病理特征之间的关系,结合临床随访资料,用Kaplan-Meier法绘制生存曲线,Log-rank法比较E-cadherin高表达组和E-cadherin低表达组5年生存率,Cox多因素回归法分析喉癌预后的独立预测因素。结果喉癌组织中E-cadherin平均染色分数明显低于癌旁非肿瘤组织(F=10.587,P<0.001);喉癌组织中E-cadherin表达水平与淋巴结转移(χ2=2.469,P<0.001)有明显相关性,而与患者年龄、肿瘤临床分型、T分级和病理分级无关;E-cadherin高表达组5年生存率为74.1%,E-cadherin低表达组5年生存率为42.9%,二者差异有统计学意义;多变量Cox风险比例模型分析表明,仅淋巴结转移是喉癌预后的独立预测因子,E-cadherin表达水平不能单独预测疾病的预后。结论E-cadherin在喉癌组织中表达减低,其表达水平可能作为预测喉癌颈淋巴结隐匿性转移的潜在肿瘤标志物。

OBJECTIVE To study the expression of E-cadherin and its relationship with clinicopathological features and prognosis of the laryngeal squamous cell carcinoma, and to explore its role in the carcinogenesis and progression of the laryngeal squamous cell carcinoma. METHODS The expression level of E-cadherin in 64 tumor tissues and 30 adjacent non-tumor laryngeal tissues were determined by immunohistochemistry method. Relationship between E-cadherin staining scores and clinicopathological parameters were analyzed. Survival curves were calculated using the Kaplan-Meier method. Differences in 5-year survival rate were analyzed by the log-rank test in different E-cadherin expression groups. Multivariate Cox proportional hazards models were used to examine the relative impact of either variable on the disease prognosis. RESULTS The mean staining score of 64 carcinoma tissues was significantly lower than that of 30 non-tumor laryngeal tissues(P<0.001). The expression of E-cadherin were significantly correlated with lymph node metastases(P<0.001). The differences of E-cadherin expression between the different age, primary site, T stage and histological differentiation groups were not statistically significant. The 5-year survival rate in high E-cadherin expression group was significantly increased than that in low E-cadherin expression group. The result of multivariate Cox proportional hazards model confirmed that only the presence of cervical lymph node metastasis was a statistically significant independent predictor of prognosis. E-cadherin expression cannot predicate the prognosis independently. CONCLUSION The expression of E-cadherin is decreased in the laryngeal squamous cell carcinoma, it might be a potential tumor marker for occult lymph node metastasis.