IGFBP-3的表达水平对食管鳞癌放疗疗效和预后的影响

Insulin-like Growth Factor Binding Protein-3 Is a New Target to Improve Effect of Radiotherapy and Prognosis on Esophageal Squamous Cell Carcinoma

【目的】探讨食管鳞癌(ESCC)组织中胰岛素样生长因子结合蛋白3(IGFBP-3)的表达水平对接受单纯放疗的食管鳞癌患者的疗效和预后的影响。【方法】选取70例接受单纯放疗的食管鳞癌病例活检组织标本,采用免疫组织化学方法检测放疗前组织中IGFBP-3的表达情况。我们又应用western blot技术检测10对食管鳞癌新鲜手术标本及癌旁无瘤组织标本IGFBP-3的表达水平,然后联合食管鳞癌临床病理参数,用χ2检验探讨其表达与放疗疗效关系,用分析Kaplan-Meier方法和Cox回归法分析其与预后的关系。【结果】在食管鳞癌活检组织中IGFBP-3呈现高表达的比例为45.7%(32/70)。70%患者食管鳞癌新鲜手术标本IGFBP-3的表达水平明显低于相应的癌旁组织。IGFBP-3的表达与T、N和M分期及临床分期和患者的放疗疗效相关(P<0.05)。IGFBP-3高表达者放疗有效率较高,为83.33%,且3年生存率亦高于IGFBP-3低表达者。【结论】IGFBP-3高表达患者的放疗敏感性,及生存期均优于IGFBP-3低表达患者(P<0.001)。IGFBP-3有望成为评价食管鳞癌放疗疗效的独立预后因素。

[Objective] To assume that insulin-like growth factor binding protein-3 （IGFBP-3） has an effect on radiotherapeutic effect and prognosis for esophageal squamous cell carcinoma （ESCC）.The present study was designed to investigate the clinical and prognostic significance of IGFBP-3 in ESCC patients.[Methods] IGFBP-3 was detected by immunohistochemistry （IHC） in paraffinembedded tissues from 70 ECSS patients who treated with radiotherapy alone.IGFBP-3 was further examined by western blotting analysis in 10 pair of fresh ESCC tissues and adjacent non-malignant esophageal specimens.Differences in IGFBP-3 expression and clinical characteristics were compared byx2 test.Correlations between prognostic outcomes and with IGFBP-3 expression were investigated using Kaplan （｜-）Meier analysis and the Cox proportional hazards model.[Result] 45.7％ （32 of 70） ESCC tissues were defined as having a high expression of IGFBP-3.70％ ESCCs had reduced levels of IGFBP-3 protein expression compared with adjacent non-malignant esophageal tissue.In addition,IGFBP-3 expression is correlated with pathological classification （P ＜ 0.05 for T,N,and M classifications and clinical stages）.[Conclusion] Patients with higher levels of IGFBP-3 had a better radiotherapy effect and prolonged overall survival （P ＜ 0.001）.Higher level of IGFBP-3 expression may be a positive factor for advanced clinicopathological classification and prolonged patient survival.Our data suggest that IGFBP-3 may serve as a potential predictor for radiosensitivity and prognostic evaluation in ESCC patients treated with RT.