TRAF6表达对食管癌放疗疗效的预测价值

Predictive value of TRAF6 expression in the efficacy of radiotherapy for esophageal cancer

目的探讨肿瘤坏死因子受体相关因子6(TRAF6)表达对食管鳞状细胞癌(ESCC)放疗疗效的预测价值。方法选取2012年2月至2015年3月在江苏省宜兴市肿瘤医院接受根治性放疗的ESCC患者278例,采用免疫组织化学法检测TRAF6在食管癌组织中的表达,并探讨TRAF6表达与ESCC患者临床病理特征、放疗近期疗效和生存的相关性。结果所有患者分为阳性表达组(n=194)和阴性表达组(n=84),TRAF6表达与ESCC患者TNM分期和淋巴结转移显著相关(χ2=13.670,P<0.001;χ2=45.497,P<0.001)。TRAF6阳性表达组放疗总有效率为62.9%(122/194),明显低于TRAF6阴性表达组的92.9%(78/84),二者差异有统计学意义(χ2=26.085,P<0.001)。TRAF阳性表达组中位生存时间为51个月,TRAF阴性表达组中位生存时间未达到,两组生存曲线差异有统计学意义(χ2=7.952,P=0.005)。进一步分析表明,较高TNM分期、淋巴结转移、TRAF6阳性表达可增加ESCC患者死亡风险(HR=1.96,95%CI为1.39~2.76;HR=1.72,95%CI为1.29~2.29;HR=2.31,95%CI为1.57~3.39)。结论TRAF6阳性表达ESCC患者的放疗敏感性低,TRAF6有可能成为ESCC患者诊断和治疗的新靶点,为ESCC的诊疗和预后提供了新思路。

Objective To investigate the predictive value of tumor necrosis factor receptor-associated factor 6(TRAF6)expression in the efficacy of radiotherapy for patients with esophageal squamous cell carcinoma(ESCC).Methods A total of 278 patients with ESCC received radical radiotherapy in Yixing Cancer Hospital of Jiangsu Province from February 2012 to March 2015 were included.The expression of TRAF6 in esophageal cancer tissue was detected by immunohistochemistry.The correlations between the expression of TRAF6 and clinicopathological features,short-term efficacy of radiotherapy and survival of ESCC patients were investigated.Results All the patients were divided into positive expression group(n=194)and negative expression group(n=84).TRAF6 expression was significantly associated with TNM stage and lymph node metastasis in ESCC patients(χ2=13.670,P<0.001;χ2=45.497,P<0.001).The total effective rate of radiotherapy in the TRAF6 positive expression group was 62.9%(122/194),which was significantly lower than that of TRAF6 negative expression group(92.9%,78/84),and the difference was statistically significant(χ2=26.085,P<0.001).The median survival time of TRAF positive expression group was 51 months,while that of TRAF negative expression group was not reached,and the difference of survival curve between the two groups was statistically significant(χ2=7.952,P=0.005).Further analysis showed that higher TNM stage,lymph node metastasis and positive expression of TRAF6 increased the risk of death in ESCC patients(HR=1.96,95%CI:1.39-2.76;HR=1.72,95%CI:1.29-2.29;HR=2.31,95%CI:1.57-3.39).Conclusion Patients with TRAF6 positive expression of ESCC have low radiotherapy sensitivity.TRAF6 may be a new target for diagnosis and treatment of ESCC patients,which provides a new idea for the diagnosis,treatment and prognosis of ESCC.