瘦素和脂联素在食管鳞癌中的表达及其临床意义

Expression of leptin and adiponectin in esophageal squamous cell carcinoma and their clinical significance

目的 初步探讨脂肪因子瘦素和脂联素在食管鳞癌（ESCC）中表达及其临床病理意义.方法 采用免疫组化方法检测ESCC组织和癌旁正常食管黏膜组织中瘦素和脂联素的表达情况,分析其与ESCC患者临床病理特征之间的相关性.结果 瘦素蛋白表达于ESCC和癌旁正常食管黏膜组织的细胞质和细胞膜中,脂联素蛋白表达于细胞核中.ESCC组织中瘦素蛋白阳性率为65.6％（80/122）,食管正常黏膜组织中瘦素蛋白阳性率为27.5％ （11/40）,差异有统计学意义（P ＜0.001）.ESCC组织中脂联素蛋白阳性率为22.1％ （27/122）,食管正常黏膜组织中脂联素蛋白阳性率为47.5％ （19/40）,差异有统计学意义（P =0.002）.瘦素蛋白表达与ESCC淋巴结转移、TNM分期有关（P =0.009,P=0.043）,脂联素蛋白表达与ESCC淋巴结转移有关（P =0.020）.相关性分析显示,瘦素蛋白表达与ESCC淋巴结转移和TNM分期呈正相关（r=0.235,r=0.183）,脂联素蛋白表达与ESCC淋巴结转移呈负相关（r=-0.229）,瘦素蛋白表达与脂联素蛋白表达无关（P＞0.05）,体重指数（BMI）与瘦素、脂联素表达及淋巴结转移无关（均P＞0.05）.结论 ESCC组织中存在脂肪因子的失衡表达.瘦素蛋白过表达和脂联素蛋白低表达均与ESCC淋巴结转移相关.脂肪因子可能也参与了ESCC的发生与发展。

Objective To preliminarily investigate the expression and clinical significance of leptin and adiponectin in esophageal squamous cell carcinoma （ESCC）.Methods The expression of leptin and adiponectin in ESCC and normal esophageal mucosal tissue was detected by immunohistochemical staining with tissue microarray.The correlation between leptin,adiponectin and clinicalpathological features was statistically analyzed.Results The expression of leptin was significantly upregulated in the ESCC than in the normal esophageal mucosa tissue [65.6% （80/122） versus 27.5 % （11/40）,P 〈 0.001].Expression of leptin was significantly correlated with lymph node involvement and advanced tumor stage （P =0.009 and P =0.043,respectively）.Expression of adiponectin was significantly down-regulated in ESCC compared with that in normal esophageal mucosal tissue [22.1% （27/122） versus 47.5% （19/40）,P =0.002].Expression of adiponectin was significantly correlated with lymph node involvement （P =0.020）.Correlation analysis showed a positive correlation between the expression of leptin and lymph node metastasis and TNM stage （r =0.235 and r =0.183,respectively）,and a negative correlation between the expression of adiponectin and lymph node metastasis （r =-0.229）.There was no significant correlation between the expressions of leptin and adiponectin （P 〉 0.05）,and between the body mass index and the expression of leptin and adiponectin,and lymph node metastasis （P 〉 0.05 for all）.Conclusions An imbalanced expression of adipocytokines exits in ESCC.The expression of leptin and adiponectin is correlated with lymph node metastasis and/or tumor stage.Therefore,imbalanced expression of leptin and adiponectin may have a potential role in the carcinogenesis and disease progression of ESCC.