ChREBP在食管鳞状细胞癌组织中的表达及其临床意义

Expression of ChREBP in esophageal squamous cell carcinoma and its clinical significance

目的探讨食管鳞状细胞癌(ESCC)组织中碳水化合物反应元件结合蛋白(ChREBP)的表达及其与预后的关系。方法采用免疫组织化学法检测2009年1月至2010年12月90例ESCC组织及对应癌旁组织中ChREBP的表达水平,分析ChREBP在ESCC及癌旁组织中的表达差异;同时进一步分析ChREBP表达与ESCC临床病理特征及预后的关系。结果ESCC组织的免疫组化评分中位数为1.90(1.50,2.10),癌旁组织为0.50(0.21,0.90),差异有统计学意义(P=0.000)。ESCC组织中ChREBP的低表达率为20.7%(18/87),低于癌旁组织的89.3%(75/84);ESCC组织中ChREBP的中表达率为67.8%(59/87),高于癌旁组织的10.7%(9/84);ESCC组织中ChREBP的高表达率为11.5%(10/87),而癌旁组织中无ChREBP高表达。ESCC组织中ChREBP的中、高表达率显著高于癌旁组织(P<0.001)。ESCC组织中ChREBP表达与组织分化程度和淋巴结转移有关(P<0.05),低分化、合并淋巴结转移的癌组织中ChREBP水平上调。ChREBP表达与性别、年龄、肿瘤大小、病理形态和TNM分期无关(P>0.05)。全组中位OS为20.0(95%CI:11.87~28.13)个月。ChREBP低表达、中表达、高表达患者的中位OS分别为26.0(95%CI:13.60~38.40)个月、20.0(95%CI:8.58~31.42)个月和15.0(95%CI:0~32.53)个月。随着ChREBP表达水平升高,患者中位OS呈下降趋势,但差异无统计学意义(P=0.53)。结论ESCC组织中ChREBP表达水平上调,且其表达水平与组织分化程度和淋巴结转移有关,ChREBP高表达患者可能预后不良。

Objective To explore the expression and clinical value of carbohydrate response element binding protein(ChREBP)in esophageal squamous cell carcinoma(ECSS).Methods Immunohistochemistry was applied to detect the expression of ChREBP in ESCC tissues and adjacent tissues in 90 patients from January 2009 to December 2010.The differential expression of ChREBP in ESCC tissues and adjacent tissues was analyzed.The relationship of ChREBP expression with clinicopathological parameters as well as prognosis was further analyzed.Results The median immunohistochemistry score of ESCC tissues was 1.90(1.50,2.10)and 0.50(0.21,0.90)for adjacent tissues(P=0.000).The low expression rate of ChREBP in ESCC tissues was 20.7%(18/87),which was lower than that of 89.3%(75/84)in adjacent tissues.The medium expression rate of ChREBP in ESCC tissues was 67.8%(59/87),which was higher than that of 10.7%(9/84)in adjacent tissues.The high expression rate of ChREBP in ESCC tissues was 11.5%(10/87),while there was no high expression of ChREBP in adjacent tissues.Compared with adjacent tissues,the high and medium expression rate was higher in ESCC tissues(P<0.001).ChREBP expression in ESCC tissues was associated with tissue differentiation and lymph node metastasis(P<0.05),and the level of ChREBP in poorly differentiated tissues complicated with lymph node metastasis was up-regulated.ChREBP expression was independent of gender,age,tumor size,pathological morphology and TNM stage(P>0.05).The median OS was 20.0(95%CI:11.87-28.13)months.The median OS of patients with low,medium and high ChREBP expression was 26.0(95%CI:13.60-38.40)months,20.0(95%CI:8.58-31.42)months and 15.0(95%CI:0-32.53)months,respectively.With the increase of ChREBP expression level,the median OS of patients showed a downward trend,but the difference was not statistically significant(P=0.53).Conclusion ChREBP expression is significantly up-regulated in ESCC tissues,which has a relationship with histological grade and lymphnode metastasis.The over-expression of ChREBP in ESCC tissues indicates poor differentiation and tumor metastasis,and may be related to poor prognosis.