食管鳞状细胞癌的癌内异质性与化疗药物耐药性的相关性探讨

Correlation study of tumor heterogeneity and chemotherapy drug resistance in esophageal squamous cell carcinoma

目的:探讨食管鳞状细胞癌(ESCC)的癌内异质性与化疗药物耐药性的相关性。方法:选取2017年1月至2018年1月我院经组织病理学诊断为ESCC并随即进行手术的121例患者,对所有患者的HE染色切片进行阅片筛选出具有癌内异质性的ESCC患者,并用MTT法检测相应癌组织对化疗药物的敏感性,分析ESCC的癌内异质性与化疗药物耐药性的相关性。结果:共有45例ESCC患者被筛选出具有癌内异质性,将其与76例无癌内异质性的患者进行资料对比,发现两者除性别、年龄、肿瘤部位等资料对比无显著差异之外,其他指标组间对比均具有统计学差异(P<0.05)。环磷酰胺、5-氟尿嘧啶、吉西他滨、长春瑞滨、紫杉醇、顺铂化疗药在ESCC组织中药物敏感性试验结果与其相应组织的癌内异质性进行Spearman秩相关检验,P值均<0.05,相关系数r分别为0.456、0.512、0.435、0.549、0.521、0.672,均呈正相关。结论:ESCC癌内异质性的存在导致了肿瘤对化疗药物耐药的异质性,两者呈正相关关系,可影响化疗疗效。

Objective:To study the correlation of tumor heterogeneity and chemotherapy drug resistance in esophageal squamous cell carcinoma(ESCC).Methods:121 ESCC patients histopathologically confirmed from January 2017 to January 2018 in our hospital were selected.HE staining and sectioning was performed to screen out ESCC patients with tumor heterogeneity.MTT assay was used to study the chemotherapy drug sensitivity in the tumor.The correlation of tumor heterogeneity with drug resistance was analyzed.Results:A total of 45 ESCC patients had tumor heterogeneity.The patients’gender,age and tumor position between heterogeneity patients and non-heterogeneity patients were not significantly different,but the other index between groups showed statistically significant difference(P<0.05).According to drug sensitivity results of cyclophosphamide,5-fluorouracil,gemcitabine,vinorelbine,paclitaxel and cisplatin in ESCC tissues,Spearman’s rank correlation test on tumor heterogeneity indicated P<0.05 while the correlation coefficient r was 0.456,0.512,0.435,0.549,0.521 and 0.672.There was positive correlation with each other.Conclusion:The tumor heterogeneity is positively correlated with chemotherapy drug resistance,which may produce a positive effect in the chemotherapy response.