血管生成拟态和E-cad在食管鳞状细胞癌中的表达及临床意义

目的 探讨血管生成拟态( vasculogenic mimicry,VM)与E-钙粘蛋白(E-cadherin,E-cad))在食管鳞癌(esophageal squamous cell carcinoma)组织中的表达及意义.方法 收集食管鳞状细胞癌术后标本100例和30例癌旁正常食管黏膜,应用免疫组化法和组织化学法检测食管鳞状细胞癌和正常食管黏膜组织中VM和E-cad的表达情况.结果 在食管鳞状细胞癌组织和正常食管黏膜组织中,VM和E-cad的阳性表达率分别为47.0％、48.0％和0％、70.0％,差异有统计学意义(P＜0.05)；VM及E-cad的表达与食管鳞癌的组织学分级、临床分期及淋巴结转移(P＜0.05)；VM与E-cad在食管鳞癌中的表达呈负相关(r=-0.865,P=0.000).多因素分析:PTNM分期、淋巴结转移、VM和E-cad的表达是影响食管鳞癌根治术后患者预后的独立因素(P＜0.05)；VM阳性组与阴性组的5年生存率分别为4.3％和64.2％,,差异有统计学意义(P=0.000)；E-cad阳性组与阴性组5年生存率分别为60.4％和15.4％,差异有统计学意义(P=0.000).结论 具有VM结构的食管鳞状细胞癌的分化程度低,恶性度高,预后差,VM和E-cad表达的程度与食管鳞状细胞癌的进展和预后密切相关.

Expression and significance of vasculogenic mimicry and E-cad in esophageal squamous cell carcinoma

Objective To explore whether vascu~ogenie mimicry（VM） exists in esophageal squamous cell cancer or not and to elucidate the relationship between the expression of E cad and VM. Methods The expression of E-cad and VM in 100 specimens of esophageal squamous cell carcinoma and 30 specimens of normal mucosa were detected by immunohistochemical and histochemical staining. Results The positive rates of VM and E-cad protein in esophageal squamous cell carcinoma were 47.0 % and 48.0 ~, respective- ly, the positive rates of VM and E-cad protein in specimens of normal mucosa were 0% and 70.0%, and there was a significant difference between the two （P〈0.05）. Expression of VM and E cad in esophageal squamous cell carcinoma was significantly related to differentiation,PTNM stage and lymphnode metasta- sis （P〈 0.05）. There was a negative relationship between the expression of E-cad and VM （r=-0. 865 ,P =0. 000）. PTNM stage,lymphnode metastasis and expression of VM and E-cad were independent progno- sis factors of esophageal squamous cell carcinoma （P~0.05）. The five-year survival rate of the VM-posi- rive and VM-negative group was significantly different （4.3% vs 64.2 %）, while the five-year survival rate was significantly higher in the E-cad-negative group than in E-cad-positive group（15.4% vs 60.4%）. Conclusion Esophageal squamous cell carcinoma with VM had a poor differentiation and a bad clinical prognosis; the level of VM and E-cad is correlated to progression and prognosis of esophageal squamous cell carci- noma.