A Molecular Prognostic Model Predicts Esophageal Squamous Cell Carcinoma Prognosis

Background

Esophageal squamous cell carcinoma (ESCC) has the highest mortality rates in China. The 5-year survival rate of ESCC remains dismal despite improvements in treatments such as surgical resection and adjuvant chemoradiation, and current clinical staging approaches are limited in their ability to effectively stratify patients for treatment options. The aim of the present study, therefore, was to develop an immunohistochemistry-based prognostic model to improve clinical risk assessment for patients with ESCC.

Methods

We developed a molecular prognostic model based on the combined expression of axis of epidermal growth factor receptor (EGFR), phosphorylated Specificity protein 1 (p-Sp1), and Fascin proteins. The presence of this prognostic model and associated clinical outcomes were analyzed for 130 formalin-fixed, paraffin-embedded esophageal curative resection specimens (generation dataset) and validated using an independent cohort of 185 specimens (validation dataset).

Results

The expression of these three genes at the protein level was used to build a molecular prognostic model that was highly predictive of ESCC survival in both generation and validation datasets (P = 0.001). Regression analysis showed that this molecular prognostic model was strongly and independently predictive of overall survival (hazard ratio = 2.358 [95% CI, 1.391–3.996], P = 0.001 in generation dataset; hazard ratio = 1.990 [95% CI, 1.256–3.154], P = 0.003 in validation dataset). Furthermore, the predictive ability of these 3 biomarkers in combination was more robust than that of each individual biomarker.

Conclusions

This technically simple immunohistochemistry-based molecular model accurately predicts ESCC patient survival and thus could serve as a complement to current clinical risk stratification approaches.     

肝细胞肝癌E-Cadherin 蛋白的表达及其对判断肝癌肝移植 疗效的意义

目的:探讨E-Cadherin蛋白在肝细胞肝癌组织中的表达及其对判断肝癌肝移植患者预后的价值。方法:选择肝细胞肝癌行全肝移植患者68例,应用免疫组化方法检测其切除的肝癌组织和癌旁正常肝组织中E-Cadherin蛋白的表达情况,并对患者进行移植术后随访,分析E-Cadherin蛋白表达与肝癌肝移植患者预后的关系。结果:肝癌组织中E-Cadherin蛋白阳性表达率明显低于癌旁组织(P<0.01)。经Logrank检验分析显示,E-Cadherin蛋白低表达组移植后的无瘤生存率明显低于E-Cadherin蛋白高表达组(P<0.01)。多因素Cox回归分析显示,E-Cadherin蛋白表达是影响肝细胞肝癌患者肝移植术后肝癌复发的独立预后因素之一。结论:E-Cadherin蛋白表达是一个预测肝细胞肝癌患者肝移植预后的重要因子。     

肝细胞肝癌E-Cadherin蛋白的表达及其对判断肝癌肝移植疗效的意义

目的：探讨E-Cadherin蛋白在肝细胞肝癌组织中的表达及其对判断肝癌肝移植患者预后的价值。方法：选择肝细胞肝癌行全肝移植患者68例,应用免疫组化方法检测其切除的肝癌组织和癌旁正常肝组织中E-Cadherin蛋白的表达情况,并对患者进行移植术后随访,分析E-Cadherin蛋白表达与肝癌肝移植患者预后的关系。结果：肝癌组织中E-Cadherin蛋白阳性表达率明显低于癌旁组织（P〈0.01）。经Logrank检验分析显示,E-Cadherin蛋白低表达组移植后的无瘤生存率明显低于E-Cadherin蛋白高表达组（P〈0.01）。多因素Cox回归分析显示,E-Cadherin蛋白表达是影响肝细胞肝癌患者肝移植术后肝癌复发的独立预后因素之一。结论：E-Cadherin蛋白表达是一个预测肝细胞肝癌患者肝移植预后的重要因子。     

A Panel of Overexpressed Proteins for Prognosis in Esophageal Squamous Cell Carcinoma

Esophageal squamous cell carcinoma (ESCC) is a common cancer with poor prognosis. In order to identify useful biomarkers for accurately classifying prognostic risks for ESCC patients, we examined the expression of six proteins by immunohistochemistry (IHC) in 590 paraffin-embedded ESCC samples. The candidate proteins include p53, EGFR, c-KIT, TIMP1 and PI3K-p110α reported to be altered in ESCC tissues as well as another important component of PI3K, PI3K-p85α. Of the six proteins tested, p53, EGFR, c-KIT, TIMP1 and PI3K-p85α were detected with high expression in 43.0%, 36.6%, 55.9%, 70.7% and 57.1% of tumors, respectively. Significant associations were found between high expression of PI3K-p85α, EGFR and p53 and poor prognosis (P = 0.00111; 0.00001; 0.00426). Applying these three proteins as an IHC panel could divide patients into different subgroups (P<0.000001). Multivariate cox regression analysis indicated that the three-protein panel was an independent prognostic factor with very high statistical significance (HR = 2.090, 95% CI: 1.621–2.696, P = 0.00000001). The data suggest that the three-protein panel of PI3K-p85α, EGFR and p53 is an important candidate biomarker for the prognosis of patients with ESCC.     

脆性组氨酸三联体与复制蛋白A相互作用的鉴定

目的：研究脆性组氨酸三联体（Fhit）对ATR／CHKl通路的影响,确定Fhit与复制蛋白A（RPA）存在相互作用,为进一步研究Fhit特异的信号通路奠定基础。方法：将Fhit全长基因插入含GST基因的原核表达载体中,在大肠杆菌中表达纯化GST-Fhit融合蛋白,并用GST沉降技术研究Fhit与RPA是否在体外存在相互作用;在表达Fhit的人细胞中用免疫共沉淀技术分析Fhit与RPA是否在体内存在相互作用,同时用免疫荧光染色方法研究Fhit与RPA在细胞内是否可以共定位。结果：通过免疫共沉淀、免疫荧光染色及GST沉降技术,确定了Fhit与RPA在体内及体外均可以相互作用。结论：确定了Fhit与RPA之间存在相互作用,为阐明Fhit在维持基因组完整性方面的机理提供了线索。     

人乳头瘤病毒与食管癌的关系

食管癌是我国最常见的十大恶性肿瘤之一,其确切病因及发病机制仍未明了,有研究认为高危型人乳头瘤病毒(HPV)是食管癌发生的危险因素。该介绍HPV的生物学特性、HPV致食管癌机制、HPV与食管癌关系的研究方法及其评估、HPV疫苗治疗食管癌等方面的研究。     

A Novel Inflammation-Based Prognostic Score,the C-Reactive Protein/Albumin Ratio Predicts the Prognosis of Patients with Operable Esophageal Squamous Cell Carcinoma

Background

Inflammation-based prognostic scores such as the neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), Glasgow prognostic score (GPS), and modified GPS (mGPS) have been reported to have prognostic value in patients with many types of cancer, including esophageal squamous cell carcinoma (ESCC). However, the role of the C-reactive protein/Albumin (CRP/Alb) ratio in ESCC has not yet been evaluated.

Methods

A total of 468 patients suffering from histologically proven ESCC were enrolled between January 2000 and July 2010. The GPS, mGPS, NLR, PLR and CRP/Alb ratios were tested together with established prognostic factors in univariate and multivariate Cox regression analyses of overall survival (OS).

Results

The optimal cutoff level for the CRP/Alb ratio was 0.50. The CRP/Alb ratio (continuous) had higher AUC values at 12 months (0.796), 24 months (0.805), and 36 months (0.815) than the NLR, GPS and mGPS. In univariate analysis, the 5-year OS rate for patients with a CRP/Alb ratio > 0.50 was 43.4%, while the rate for patients with a CRP/Alb ratio ≤ 0.50 was 17.7% (P < 0.0001). In multivariate analysis, patients with a CRP/Alb ratio > 0.50 had worse survival than patients with a CRP/Alb ratio ≤ 0.50 (HR: 2.44; 95% CI: 1.82–3.26; P < 0.0001).

Conclusion

In summary, to the best of our knowledge, this is the first study to identify the CRP/Alb ratio as a novel inflammation-based prognostic factor in a large group of ESCC patients. The prognostic value of the CRP/Alb ratio needs to be verified in prospective multicenter studies.     

Slug Is a Predictor of Poor Prognosis in Esophageal Squamous Cell Carcinoma Patients

Background

Slug, a regulator of epithelial mesenchymal transition, was identified to be differentially expressed in esophageal squamous cell carcinoma (ESCC) using cDNA microarrays by our laboratory. This study aimed to determine the clinical significance of Slug overexpression in ESCC and determine its correlation with clinicopathological parameters and disease prognosis for ESCC patients.

Methods

Immunohistochemical analysis of Slug expression was carried out in archived tissue sections from 91 ESCCs, 61 dysplastic and 47 histologically normal esophageal tissues. Slug immunopositivity in epithelial cells was correlated with clinicopathological parameters and disease prognosis over up to 7.5 years for ESCC patients.

Results

Increased expression of Slug was observed in esophageal dysplasia [cytoplasmic, 24/61 (39.3%) cases, p = 0.001, odd’s ratio (OR) = 4.7; nuclear, 11/61 (18%) cases, p < 0.001, OR = 1.36] in comparison with normal esophageal tissues. The Slug expression was further increased in ESCCs [cytoplasmic, 64/91 (70.3%) p < 0.001, OR = 10.0; nuclear, 27/91 (29.7%) p < 0.001, OR = 1.42]. Kaplan Meier survival analysis showed significant association of nuclear Slug accumulation with reduced disease free survival of ESCC patients (median disease free survival (DFS) = 6 months, as compared to those that did not show overexpression, DFS = 18 months; p = 0.006). In multivariate Cox regression analysis nuclear Slug expression [p= 0.005, Hazard’s ratio (HR) = 2.269, 95% CI = 1.289 - 3.996] emerged as the most significant independent predictor of poor prognosis for ESCC patients.

Conclusions

Alterations in Slug expression occur in early stages of development of ESCC and are sustained during disease progression. Slug may serve as a diagnostic biomarker and as a predictor of poor disease prognosis to identify ESCC patients that are likely to show recurrence of the disease.     

胃癌组织中Bag-1蛋白表达特点及与临床病理学特征、预后的关系

目的:探讨Bc1-2相联系的抗凋亡基因1(Bag-1)蛋白在胃癌组织中的表达及与患者临床病理学特征、预后的关系。方法:选取病理科收集的79例胃癌组织及30例癌旁组织,标本收集时间2010年2月至2013年12月,采用免疫组化SP染色检测两组标本中的Bag-1蛋白表达水平,并分析Bag-1蛋白表达与胃癌患者临床病理学、预后的关系。结果:胃癌组织中的Bag-1蛋白阳性表达率65.82%显著的高于癌旁组织的13.33%(P0.05);Bag-1蛋白阳性表达的胃癌患者3年生存率30.77%显著的低于阴性表达患者的55.56%(P0.05);Bag-1蛋白阳性和阴性表达的患者1年以及2年生存率相差不大,差异无统计学意义(P0.05);Bag-1蛋白阳性表达的胃癌患者3年生存率30.77%显著的低于阴性表达患者的55.56%(P0.05)。结论:胃癌组织中的Bag-1蛋白高表达,并且与患者的胃癌临床分期和淋巴结转移以及预后有关。     

A Strong Relationship Between Oral Squamous Cell Carcinoma and DNA Repair Genes

Single nucleotide polymorphisms of DNA repair genes alter protein function and modulate DNA repair efficiency in various cancers. The X-ray repair cross-complementing group (XRCC) is responsible for the repair of DNA base damage and single-strand breaks. The aim of our study was to investigate the association of XRCC1 Arg399Gln and XRCC3 Thr241Met polymorphisms with the susceptibility to develop oral squamous cell carcinoma (OSCC) in Turkish subjects. One hundred eleven patients with OSCC and 148 healthy controls were recruited for the study. Genetic analysis was performed using polymerase chain reaction/restriction fragment length polymorphism (PCR/RFLP). We found that the XRCC1 Arg399Gln Gln/Gln genotype and Gln allele were risk factors for OSCC. Also, Arg/Arg genotype and Arg allele had protective effects against OSCC. Relative to XRCC3 Thr241Met polymorphism, carrying homozygote variants (Thr/Thr and Met/Met) was related with elevated OSCC risk. However, the heterozygote genotype and Thr allele variants were shown to be protective against OSCC. We suggest that XRCC1 Arg399Gln Gln/Gln genotype, Gln allele, and homozygote variants of XRCC3 Thr241Met polymorphism may be a risk factor for predisposition of OSCC in Turkish. In addition, XRCC3 Thr241Met genotype could be associated with tumor size and level of daily smoking.     

CT 扫描在食管癌淋巴结转移患者预后评估中的应用价值

目的:探讨CT扫描对食管癌淋巴结转移诊断的准确率及CT扫描对预测淋巴结转移患者预后的价值.方法:选择我院收入的行食管癌根治术患者共146例,患者均行CT及腹部彩超,检查者CT及腹部彩超对食管癌淋巴结转移检测的准确率及漏诊率,检测CT淋巴结转移数、CT三分区转移情况及CT最大病变直径等CT检测与食管癌淋巴结转移相关因素.结果:CT淋巴结总检出率显著高于彩超检出率,两组对比差异有统计学意义,P＜0.05.CT检测中胸上段、胸中段总检出率显著高于彩超检出率,结果对比差异有统计学意义,P＜0.05.所有患者自手术日起计算术后1、3年生存率分别为73.3％(107/146)、47.9％( 70/146),CT 转移数≥2枚、CT三分区转移＜2区、CT最大病变直径≤3cm患者术后生存率较高,结果对比差异有统计学意义,P＜0.05.结论:CT对食管癌淋巴结转移诊断率较高,CT转移数、CT三分区转移及CT最大病变直径检测可用于评估患者术后生存率情况.     

H2-Calponin 在食管鳞癌中的表达及其与食管磷癌预后的关系

目的:探讨H_2-Calponin在食管磷癌组织中的表达及其与食管磷癌患者临床病理特征及预后的相关性。方法:利用免疫组织化学染色技术检测73例食管磷癌及相应癌旁组织中H_2-Calponin的表达情况,并分析其与食管磷癌患者临床病理参数及预后的关系。结果:H_2-calponin在食管磷癌组织中的阳性表达率为95.8%(70/73),显著高于癌旁组织(35.8%,24/67),差异具有统计学意义(p0.0001)。H_2-calponin的表达与食管癌患者的性别、年龄、肿瘤大小、浸润深度及淋巴结转移均无显著相关性,但与AJCC分期显著相关(P0.05)。H_2-calponin的表达水平影响食管癌患者预后及生存期。结论:H_2-Calponin在食管磷癌组织中呈高表达并可预示食管磷癌预后不良。     

CCNG2在胃癌中的表达及其临床意义

为检测CCNG2在胃癌中的表达改变,并探讨其变化与胃癌临床参数和预后之间的关系,构建了225例胃癌组织芯片。用免疫组化检测了CCNG2的表达,分析其表达与临床病理参数及胃癌患者预后的关系。免疫组化结果显示,CCNG2在癌旁粘膜中均有表达,而胃癌中的表达率为51.1%(115/225)。CCNG2的表达与肿瘤浸润深度、淋巴结转移、疾病分期以及组织学分化呈负相关。生存分析表明,CCNG2可以是判断胃癌患者预后的独立指标。由此得出结论,CCNG2在胃癌的发生发展过程中起着重要作用,可作为判断胃癌患者预后的指标。     

脆性组氨酸三联体与复制蛋白A相互作用关键氨基酸残基的鉴定

目的：研究脆性组氨酸三联体（Fhit）对ATR/CHK1通路的影响,在确定Fhit与复制蛋白A（RPA）存在相互作用的基础上鉴定Fhit与RPA相互作用的关键氨基酸残基,为进一步研究Fhit特异的信号通路奠定基础。方法：构建一系列Fhit缺失突变体基因Fhit1～Fhit11及6种Fhit点突变体基因,将这些基因插入含GST基因的原核表达载体中,在大肠杆菌中表达并纯化GST-Fhit1～GST-Fhit11融合蛋白、突变体GST-FhitSIYEEL、GST-FhitIY、GST-FhitEL、GST-FhitF、GST-FhitA,以及GST-FhitD融合蛋白,用GST沉降技术研究Fhit与RPA相互作用的关键氨基酸残基。结果：Fhit蛋白第112～117（SIYEEL）残基可能是Fhit与RPA相互作用的关键区域,而第114（Y）残基可能是Fhit与RPA相互作用的关键氨基酸残基。结论：确定了Fhit与RPA相互作用的关键氨基酸残基,为阐明Fhit在维持基因组完整性方面的机理提供了线索。     

血清超敏C-反应蛋白水平与急性缺血性脑卒中预后的关系

目的:探讨急性缺血性脑卒中患者血清超敏C-反应蛋白(hs-CRP)的水平对卒中后功能障碍的预测价值.方法:分别在发病后第1和7天,采用颗粒增强免疫透射比浊法对92例急性缺血性脑卒中患者检测血清hs-CRP水平,并选取40例健康受试者作为对照.随访并记录患者1月、3月和6月mRS评分.结果:①急性缺血性脑卒中患者血清hs-CRP水平较对照组显著升高.②急性缺血性卒中患者入院1d和7d血清hs-CRP水平与1月、3月和6月mRS评分,均有明显的相关性.与入院1d血清hs-CRP水平相比,入院7d血清hs-CRP水平与mRS评分相关性更好.③与无颈动脉粥样硬化危险因素的缺血性卒中患者相比,有颈动脉粥样硬化危险因素的缺血性卒中患者入院7d血清hs-CRP水平明显升高.结论:与入院1d血清hs-CRP水平相比,入院7d血清hs-CRP水平对卒中后功能障碍的预测价值更好.     

支架置入技术治疗食道癌的临床疗效及预后

目的:观察支架置入法对食道癌患者的治疗效果及预后情况。方法:选取我院收治的食道癌患者共104例,根据治疗手段分为两组,其中对照组52例采用70 Gγ7/周治疗方案;实验组52例给予支架置入法治疗。对两组患者的梗阻改善情况、生存质量评分、并发症及生存情况进行统计分析。结果:1治疗后,两组患者的梗阻情况以及生存质量均得到有效改善,实验组患者的梗阻总缓解率为92.31%,生存质量评分为42.61±5.23分,均显著高于对照组,差异具有显著性(P0.05);2实验组患者的不良反应发生率(36.54%)与对照组(38.48%)比较无统计学差异(P0.05);3两组患者的3个月及6个月时的生存率相接近,但是实验组患者12个月生存率(71.7%)显著低于对照组(82.7%),差异具有统计学意义(P0.05)。结论:支架置入法能够显著改善食道癌患者的梗阻症状,提高患者生存质量,是较为安全可靠的缓解食道狭窄方法。     

食管癌组织环指蛋白2、环指蛋白6的表达与上皮-间质转化和预后的关系分析

摘要 目的：探讨食管癌组织环指蛋白2（RNF2）、环指蛋白6（RNF6）的表达与上皮-间质转化（EMT）和预后的关系。方法：选择广东医科大学附属医院2017年2月至2020年2月收治的162例食管癌患者,取手术切除的癌组织和癌旁组织。采用免疫组化法检测RNF2、RNF6以及EMT标志蛋白[上皮钙黏附素（E-cadherin）、神经型钙黏蛋白（N-cadherin）Slug 和Snail]表达。Spearman相关性分析RNF2、RNF6与EMT标志蛋白的关系;分析食管癌组织RNF2、RNF6表达在不同临床病理特征中的差异;Kaplan-Meier生存曲线分析RNF2、RNF6表达与食管癌患者预后的关系;多因素Cox回归分析影响食管癌患者预后的因素。结果：食管癌组织RNF2、RNF6、N-cadherin、Slug和Snail蛋白阳性表达率高于癌旁组织,E-cadherin蛋白阳性表达率低于癌旁组织（P＜0.05）。食管癌组织RNF2、RNF6蛋白阳性表达率与N-cadherin、Slug和Snail蛋白阳性表达率呈正相关,与E-cadherin蛋白阳性表达率呈负相关（P＜0.05）;低度分化、TNM分IIIA期、肿瘤直径≥2 cm、淋巴结转移在食管癌组织中RNF2、RNF6蛋白阳性表达率高于无淋巴结转移、肿瘤直径＜2 cm,中高度分化、TNM分期I～II期食管癌组织（P＜0.05）;RNF2阳性表达患者3年OS率为47.17%,低于RNF2阴性表达患者的59.26% （P＜0.05）,RNF6阳性表达患者3年OS率为47.06%,低于RNF6阴性表达患者的63.41%（P＜0.05）;多因素Cox回归分析显示TNM分期ⅢA期、淋巴结转移、RNF2阳性表达、RNF6阳性表达是食管癌患者预后的危险因素（P＜0.05）。结论：食管癌组织中RNF2、RNF6阳性表达率增加,且与肿瘤直径、分化程度、TNM分期、淋巴结转移以及低生存率有关,RNF2、RNF6可能通过EMT参与食管癌恶性进展过程。