食管鳞状细胞癌中FOXA1蛋白表达及预后意义

Expression and prognostic significance of FOXA1 protein in esophageal squamous cell carcinoma

目的观察叉头盒蛋白A1(forkhead box protein A1,FOXA1)在食管鳞状细胞癌(esophageal squamous cell carcinoma,ESCC)中的表达及其与临床病理特征和预后的关系。方法采用免疫组化SP法检测532例ESCC芯片组织中FOXA1蛋白表达,分析FOXA1蛋白表达与临床病理特征及预后的相关性。结果532例ESCC组织中183例呈FOXA1高表达(34.4%)。FOXA1高表达与ESCC脉管内癌栓(P=0.032)、肿瘤低分化程度(P=0.032)和肿瘤大小(P<0.001)相关。Ⅰ+Ⅱ期ESCC FOXA1高表达患者的总生存期(overall survival,OS)和无瘤生存期(disease free survival,DFS)均有缩短趋势(OS:P=0.094;DFS:P=0.107)。生存期≥24个月的ESCC患者,FOXA1高表达组OS和DFS显著缩短(OS:P=0.048;DFS:P=0.047)。多因素生存分析显示,肿瘤浸润深度是影响ESCC患者预后的独立危险因素。结论FOXA1在ESCC中高表达,其高表达与肿瘤大小、脉管内癌栓和低分化程度相关。FOXA1高表达组OS和DFS有预后较差的趋势,当患者的OS和DFS≥24个月时,FOXA1高表达可能作为ESCC患者预后不良的参考指标。

Purpose To investigate the expression of forkhead box protein A1(FOXA1)in esophageal squamous cell carcinoma(ESCC)and its association with clinicopathologic characteristics and prognosis.Methods Immunohistochemistry was used to detect FOXA1 protein expression in 532 cases of esophageal squamous cell carcinoma.The correlation between FOXA1 protein expression and clinicopathologic features and prognosis of patients was analyzed.Results In 532 cases of esophageal squamous cell carcinoma,183 cases overexpressed FOXA1 protein(34.4%).FOXA1 overexpression was associated with ESCC vascular infiltration(P=0.032),poorly differentiation(P=0.032),and tumor size(P<0.001).The overall survival(OS)and disease free survival(DFS)of patients with stageⅠ+Ⅱesophageal squamous cell carcinoma with high FOXA1 expression tended to be poor(OS:P=0.094;DFS:P=0.107).In ESCC patients with survival longer than 24 months,the high FOXA1 expression group had significantly shorter OS and DFS(OS:P=0.048;DFS:P=0.047).Multivariate survival analysis showed that the depth of tumor invasion was an independent prognostic factor affecting the prognosis of esophageal squamous cell carcinoma.Conclusion FOXA1 is overexpressed in esophageal squamous cell carcinoma,and its high expression is related to tumor size,vascular infiltration and poorly differentiation.Patients with high FOXA1 expression tended to have poor prognosis in OS and DFS.When OS and DFS≥24 months,high FOXA1 expression may be used as a reference indicator for poor prognosis in ESCC patients.