真核细胞翻译起始因子和雷帕霉素靶蛋白在食管鳞癌组织中表达的临床意义

Clinical significance of the expression of eukaryotic initiation factor 4 E and mammalian target of ;rapamycin in esophageal squamous carcinoma tissues

目的：探讨真核细胞翻译起始因子（eIF4E）与雷帕霉素靶蛋白（mTOR）在食管鳞癌组织中表达的临床意义。方法回顾性收集2010年1月至2012年12月在中山大学附属第一医院胸外科行手术切除的148例食管鳞癌患者的临床资料及肿瘤组织石蜡标本，应用Western blot和免疫组织化学（免疫组化）染色检测食管鳞癌组织、癌旁不同距离组织中eIF4E与mTOR的表达情况，并分析其与本组患者临床病理特征的关系。结果 mTOR主要表达于细胞质，而elF4E阳性部位位于细胞膜，呈棕黄色颗粒；两种标记物在癌组织中强表达，在癌旁组织呈弱表达或不表达。食管鳞癌组织、癌旁1 cm组织及癌旁5 cm组织中，mTOR蛋白的表达分别为85．8％（127／148）、35．1％（52／148）及3．4％（5／148），eIF4E蛋白分别为93．9％（139／148）、35．1％（52／148）及12．8％（19／148），均呈明显下降趋势（均P＜0．05）。 mTOR和eIF4E的表达均与肿瘤浸润深度和有无淋巴结转移有关（均P＜0．05），其中mTOR表达还与肿瘤分化程度有关（P＝0．003），而eIF4E表达与肿瘤分化程度无关（P＝0．062）。两者的表达均与患者性别、年龄、肿瘤大小无关（P＞0．05）。结论 eIF4E与mTOR在食管鳞癌组织中呈过度表达，可能与肿瘤恶性程度和淋巴结转移有关，两者联合检测可能有助于对食管鳞癌恶性程度及预后的判断。

Objective To explore the clinical significance of eukaryotic initiation factor 4 E （eIF4E） and mammalian target of rapamycin （mTOR） expressions in esophageal squamous carcinoma tissues. Methods Clinicopathological data and paraffin samples of resected tumor tissue from 148 patients with esophageal squamous carcinoma undergoing resection in our department between January 2010 and December 2012 were collected retrospectively. Expressions of eIF4E and mTOR were detected in above carcinoma tissues, counterpart para-carcinoma tissues（1 cm distance to carcinoma） and normal tissues （5 cm distance to carcinoma） with Western blot and immunohistochemistry. Their relevance with clinicopathological features was analyzed. Results Expression of mTOR located mainly in cytoplasm and elF4E mainly in cellular membrane, presenting as yellow grains. These two markers showed strong expression in carcinoma tissues and weak or none in para-carcinoma tissues. In esophageal squamous carcinoma tissues, counterpart para-carcinoma tissues and normal tissues, mTOR protein expression was 85.8%（127/148）, 35.1%（52/148） and 3.4%（5/148）, eIF4E protein expression was 93.9%（139/148）, 35.1%（52/148） and 12.8%（19/148）, with a downtrend respectively （all P〈0.05）. Expressions of mTOR and eIF4E were associated with tumor invasion depth and lymphatic metastasis （all P〈0.05）, while mTOR expression was associated with differentiation degree （P=0.003）, but eIF4E expression was＇not. Both expressions were not associated with gender, age, and tumor size （all P〉0.05）. Conclusions Expressions of eIF4E and mTOR are up-regulated in esophageal squamous carcinoma tissues , which may be associated with tumor malignance and lymphatic metastasis of esophageal squamous carcinoma. Combined detection of two markers may be helpful to predict the tumor malignance and the prognosis of patients.