黏蛋白1在食管鳞癌中的表达及其与临床病理特征及预后的关系

Expression of Mucin-1 in esophageal squamous cell carcinoma and its relationship with clinical pathology and prognosis

目的 探讨黏蛋白1（MUC1）在食管鳞癌和正常食管组织中的表达与临床病理特征及预后的关系.方法 采用免疫组织化学法检测76例食管鳞癌组织和19例正常食管黏膜组织MUC1的表达;采用χ2检验判断其相关性、Kaplan-Meier法进行生存分析、Log-rank检验判断生存差异性、采用Cox比例风险模型进行多因素分析判定独立预后因素.结果 MUC1在正常食管黏膜仅在细胞膜及部分细胞核微弱表达,而在食管鳞癌组织中,MUC1以细胞核表达为主,部分表达于细胞膜,这与MUC1作为一种跨膜糖蛋白在正常组织中的定位不完全相同.MUC1在食管鳞癌组织与正常食管黏膜组织中表达的阳性率分别为72.4％（55/76）和10.5％ （2/19）,两者差异有统计学意义（P＜0.01）;食管鳞癌患者中,有、无淋巴结转移者的MUC1阳性表达率分别为86.1％（31/36）和60.0％（24/40）,两者差异有统计学意义（P＜0.01）.伴有MUC1阳性表达患者的5年生存率为16.4％（9/55）,阴性表达患者5年生存率为47.6％（10/21）,两者差异有统计学意义（P＜0.01）.Cox回归分析显示,N分期（P＜0.01）及MUC1的阳性表达（P＜0.05）是独立的预后不良因素.结论 MUC1在食管鳞癌组织中表达增高且以细胞核表达为主,MUC1与淋巴结转移相关.伴有MUC1阳性表达患者的5年生存率明显低于阴性表达患者,MUC1可以作为评估患者预后的分子生物学指标.

Objective To investigate the expression of gene Mucin 1 （MUC1） in esophageal squamous cell carcinoma （ESCC） and normal esophageal mucosa tissues,and explore its relationship with clinicopathological characteristics and prognosis.Methods Streptavid-in-peroxidase （SP） immunohistochemistry was used to study the expression of MUC1 in 76 cases of ESCC tissues and 25 cases of normal esophageal mucosa tissues.The survival rate was calculated by Kaplan-meier method and the difference was determined by the log-rank test.The Cox regression analysis was performed to determine the independent risk factors for lymph-metastastic recurrence.Results The expression of MUC1 protein was detected in the cell membrane and part of the nucleus weakly in normal esophageal mucosa tissues,and in the nucleus and part of the cell membrane in ESCC.It did not conform to that MUCI was a kind of transmembrane glycoprotein in the normal tissues.The expression positive rate of MUC1 was 72.4% （55/76） in ESCC tissues and 10.5% （2/19） in normal esophageal mucosa tissues with significant difference （P 〈 0.01）.There was a positive correlation between MUC1 positive expression and lymphatic metastasis （P 〈 0.01）.The 5-year survival rate of patients with MUC1 positive expression and without MUC1 positive expression was separately 16.4% and 47.6% with significant difference （P 〈0.01）.The Cox regression analysis showed that the positive expression of MUC1 （P 〈 0.05） and the lymphatic metastasis （P 〈 0.01） were independent risk factors.Conclusion The high expression of MUC1 protein was detected in ESCC and most was in the nucleus.The 5-year survival rate of patients with MUC1 positive expression was significantly lower than that with MUC1 negative patients.The high expression of MUC1 protein is an independent risk factor and can be used as a biomarker of poor prognosis.