【摘要】：目的檢測(cè)食管鱗癌組織中REG Iα的表達(dá)情況,分析REG Iα表達(dá)情況與臨床病理特征及生存間關(guān)系,并進(jìn)一步探討REG Iα表達(dá)狀態(tài)與輔助化療的關(guān)系。方法回顧性分析2008-1-1至2010-12-31天津醫(yī)科大學(xué)腫瘤醫(yī)院II/III期單純手術(shù)或者術(shù)后接受氟尿嘧啶聯(lián)合順鉑方案(FP)輔助化療的食管鱗癌患者(N=135)臨床隨訪資料,采用免疫組織化學(xué)S-P方法檢測(cè)REG Iα的表達(dá)情況,采用卡方檢驗(yàn)分析REG Iα表達(dá)狀態(tài)與腫瘤原發(fā)病灶部位、腫瘤浸潤深度(T分期)、TNM分期、淋巴結(jié)轉(zhuǎn)移(N分期)、腫瘤組織分化程度(分級(jí))、總生存期等臨床病理特征之間的相關(guān)性,結(jié)合REG Iα的表達(dá)情況及隨訪資料,Kaplan-Meier法和Log-rank檢驗(yàn)分析REG Iα與食管癌患者生存的相關(guān)性;建立Cox回歸模型評(píng)估REG Iα及各臨床病理因素與患者生存的相關(guān)性,并采用Kaplan-Meier法和Log-rank檢驗(yàn)進(jìn)一步探討REG Iα表達(dá)狀態(tài)與輔助化療患者生存的關(guān)系。結(jié)果REG Iα在食管鱗癌組織中表達(dá)陽性率為43.70%(59/135),其表達(dá)狀態(tài)與各臨床病理特征間相關(guān)性無統(tǒng)計(jì)學(xué)意義。在所有食管鱗癌患者中,REG Iα表達(dá)陽性者較其表達(dá)陰性者3年生存率低,差異有統(tǒng)計(jì)學(xué)意義(χ2=6.811,P=0.009)。在單純手術(shù)組中(N=82),REG Iα表達(dá)陽性患者3年生存率明顯低于REG Iα表達(dá)陰性患者(25.00%vs.52.08%,χ2=9.725,P=0.002),且REG Iα表達(dá)陽性為單純手術(shù)組患者的一個(gè)獨(dú)立預(yù)后因素;而在輔助化療組(N=53),REG Iα表達(dá)陽性患者3年生存率與其表達(dá)陰性患者無統(tǒng)計(jì)學(xué)意義(57.69%vs.52.08%,χ2=0.696,P=0.404)。在所有食管鱗癌患者中,輔助化療者較單純手術(shù)者3年生存率有提高趨勢(shì)(58.49 vs.42.68,χ2=2.822,P=0.093),但差異無統(tǒng)計(jì)學(xué)意義,分層分析顯示對(duì)于REG Iα表達(dá)陽性患者、淋巴結(jié)轉(zhuǎn)移陽性患者及吸煙指數(shù)≥400患者,接受輔助化療者較單純手術(shù)者3年生存率明顯提高(62.50%vs.27.27%,χ2=5.115,P=0.024;51.43%vs.28.13%,χ2=5.421,P=0.020;60.71%vs.28.57%,χ2=4.737,P=0.030),差異有統(tǒng)計(jì)學(xué)意義。結(jié)論食管鱗癌患者REG Iα表達(dá)狀態(tài)與其生存相關(guān),即REG Iα表達(dá)陽性患者生存差;同時(shí)也能夠提示輔助化療敏感性,即REG Iα表達(dá)陽性患者可能從輔助化療中獲益。
[Abstract]:Objective to detect the expression of REG I 偽 in esophageal squamous cell carcinoma, to analyze the relationship between the expression of REG I 偽 and clinicopathological features and survival, and to explore the relationship between the expression of REG I 偽 and adjuvant chemotherapy. Methods the clinical follow-up data of patients with esophageal squamous cell carcinoma (NQ135) receiving fluorouracil plus cisplatin regimen (FP) were analyzed retrospectively from 2008-1-1 to 2010-12-31, stage II / III surgery or adjuvant chemotherapy of fluorouracil combined with cisplatin (FP) in Tianjin Medical University Oncology Hospital. Immunohistochemical S-P method was used to detect the expression of REG I 偽. The expression of REG I 偽 was analyzed by chi-square test. The expression of REG I 偽 and the location of the primary tumor focus, the depth of tumor invasion (T stage) and TNM stage were analyzed. The correlation between the clinicopathological features of lymph node metastasis (N stage), tumor differentiation degree (grade), total survival time, combined with the expression of REG I 偽, Kaplan-Meier method and Log-rank test were used to analyze the correlation between REG I 偽 and the survival of esophageal cancer patients. Cox regression model was established to evaluate the correlation between the survival of patients with REG I 偽 and the clinicopathological factors. Kaplan-Meier method and Log-rank test were used to further explore the relationship between the expression of REG I 偽 and the survival of patients with adjuvant chemotherapy. Results the positive rate of REGI 偽 expression in esophageal squamous cell carcinoma was 43.70% (59 / 135). In all patients with esophageal squamous cell carcinoma, the 3-year survival rate of patients with positive expression of REG I 偽 was significantly lower than that of patients with negative expression of REGI 偽 (蠂 2 = 6.811 P0. 009). The 3-year survival rate of patients with positive expression of REGI 偽 was significantly lower than that of patients with negative expression of REGI 偽 (25.00 vs.52.08, 蠂 2 9.725 P0. 002), and the positive expression of REGI 偽 was an independent prognostic factor in simple operation group. However, the 3-year survival rate of patients with positive expression of REG I 偽 in the adjuvant chemotherapy group was not significantly different from that of the patients with negative expression (57.69vs.52.08, 蠂 2 = 0.696). In all patients with esophageal squamous cell carcinoma, the 3-year survival rate of adjuvant chemotherapy group was higher than that of simple operation group (58.49 vs.42.68, 蠂 ~ 2 = 2.822, P < 0.093), but the difference was not statistically significant. Stratified analysis showed that REGI 偽 expression was positive in patients. In patients with positive lymph node metastasis and smoking index 鈮，

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