肿瘤干细胞标志物Musashi-1表达水平对可切除食管鳞癌患者新辅助化疗疗效的预测价值

The predictive value of Musashi-1 as an adjuvant chemotherapy marker for esophageal squamous cell carcinoma

目的:探讨肿瘤干细胞标志物Musashi-1对可切除食管鳞癌(ESCC)患者新辅助化疗(NCT)疗效的预测价值。方法:选择60例ESCC患者为研究对象,所有患者均在NCT后接受手术治疗,采用免疫组化检测肿瘤组织中Musashi-1的表达,根据表达强度,将患者分为Musashi-1高表达与Musashi-1低表达组。对患者进行随访,分析Musashi-1对患者治疗反应性的影响。结果:免疫组化检测显示,Musashi-1主要定位肿瘤细胞核内。60例患者中,24例为Musashi-1高表达,36例低表达。患者T分期/N分期/临床分期越高、病理分级越高,Musashi-1的表达强度就越高(P<0.05)。Musashi-1高表达组、低表达组的化疗客观应答率(ORR)分别为33.3%、69.4%,差异具有统计学意义(P=0.006)。Musashi-1高表达组无一例患者达肿瘤消退分级(TRG)1级标准,TRG2级、3级、4+5级应答率分别为20.8%、58.4%、20.8%,低表达组TRG1级、2级、3级、4+5级应答率分别为16.7%、41.7%、36.1%、5.5%,Musashi-1低表达组消退分级显著好于高表达组(P<0.05)。多因素Cox分析发现,Musashi-1表达水平、T分期、N分期和病理分级是影响患者预后的独立性危险因素(P<0.05)。Kaplan-Meier生存曲线显示Musashi-1高表达组与低表达组的中位总生存期(OS)分别为20个月、32个月,Log-rank分析显示,Musashi-1高表达组患者的总体生存率显著比低表达组患者差(P=0.035)。结论:Musashi-1高表达与ESCC患者不良预后密切相关,可作为预测NCT疗效的潜在生物标志物。

Objective:To investigate the predictive value of Musashi-1 on the efficacy of neoadjuvant chemotherapy in patients with resectable esophageal squamous cell carcinoma.Methods:Sixty ESCC patients were selected as the research objects.The expression of Musashi-1 in tumor tissues was detected by immunohistochemistry.The patients were divided into high expression group and low expression group.The patients were followed up to analyze the effect of Musashi-1 on the treatment responsiveness.Results:Musashi-1 mainly located in nucleus.Among the 60 patients, 24 had high expression of Musashi-1(MHG),36 had low expression of Musashi-1(MLG).The higher the T stage/N stage/clinical stage and the higher the pathological grade, the higher the expression intensity of Musashi-1(P<0.05).The objective response rate(ORR) of Musashi-1 high expression group and low expression group was 33.3% and 69.4%,respectively.The response rates of grade 2,grade 3 and grade 4+5 were 20.8%,58.4% and 20.8% respectively in the group with high expression of Musashi-1,and 16.7%,41.7%,36.1% and 5.5% in the group with low expression of Musashi-1.The regression grade of the low expression group was significantly better than that of the high expression group of Musashi-1(P<0.05).The expression level of Musashi-1,T stage, N stage and pathological grade were independent risk factors of prognosis(P<0.05).The median overall survival(OS) was 20 months in the MHG group and 32 months in the MLG group.The overall survival rate in the high expression group was significantly lower than that in the low expression group.Conclusion:The high expression of Musashi-1 is closely related to the poor prognosis of ESCC patients, which can be used as a potential biomarker to predict the therapeutic effect of NCT.