不同放化疗敏感性食管鳞状细胞癌中膜联蛋白A1的表达及预后因素分析

黄鑫; 陈博; 李自康; 李涛

doi:10.13898/j.cnki.issn.1000-2200.2019.10.014

不同放化疗敏感性食管鳞状细胞癌中膜联蛋白A1的表达及预后因素分析

Expression of annexin A1 in ESCC with different chemoradiotherapy sensitivity and prognostic factors of ESCC

摘要

摘要:
目的观察膜联蛋白A1（annexin A1，ANXA1）在食管鳞状细胞癌（esophageal squamous cell carcinoma，ESCC）组织中的表达情况，并探讨ANXA1与ESCC放化疗敏感性和预后的关系。
方法回顾性收集有病理学依据，接受同步放化疗ESCC的病理组织标本60例，根据RECIST标准对放化疗敏感性进行评价，将病人分为放化疗敏感组和放化疗抵抗组。应用免疫组织化学法检测ANXA1的表达，将病人分为ANXA1阳性表达组和阴性表达组，分析ANXA1表达水平与ESCC放化疗敏感性和生存预后的关系。
结果60例ESCC组织中ANXA1的阳性表达率为55.0%（33/60）；其在放化疗敏感组中的阳性表达率为62.8%（22/35），略高于放化疗抵抗组44.0%（11/25），但差异无统计学意义（P>0.05）。ANXA1的表达与ESCC病人性别、年龄、病变长度、T分级、N分级、M分级、临床分期无明显相关性（P>0.05）。KPS评分、肿瘤分化程度、病变长度、T分期、N分期、M分期、临床分期、放化疗敏感性和ANXA1的表达与病人预后密切相关（P < 0.05~P < 0.01）。Cox回归模型多因素分析显示，KPS评分、肿瘤分化程度、临床分期、放化疗敏感性、ANXA1表达是影响入组ESCC病人预后的独立危险因素（P < 0.05~P < 0.01）。ANXA1阳性表达组病人的中位总生存时间长于阴性表达组的中位总生存时间（P < 0.05）。
结论ANXA1的表达与ESCC放化疗敏感性未见明显相关性，但与ESCC病人的临床预后相关，ANXA1表达阴性提示预后不良，推测ANXA1可能是影响ESCC病人预后的独立危险因素。

Abstract:
ObjectiveTo study the expression level of annexin A1(ANXA1) in esophageal squamous cell carcinoma(ESCC), and correlations of ANXA1 with chemoradiotherapy sensitivity and prognosis of ESCC.
MethodsThe clinical data of 60 ESCC patients treated with concurrent radiochemotherapy were retrospectively analyzed, and the patients were divided into the chemoradiotherapy sensitive group and chemoradiotherapy resistance group according to the RECIST standard.The expression level of ANXA1 was detected using immunohistochemistry SP method, and the patients were divided into the ANXA1 positive and negative expression groups.The relationship between the expression level of ANXA1, and chemoradiotherapy sensitivity and prognosis of ESCC were analyzed.
ResultsThe positive expression rate of ANXA1 in 60 ESCC tissue samples was 55.0%.The positive ratios of ANXA1 expression in chemoradiotherapy sensitive group and chemoradiotherapy resistance group were 62.8%(22/35) and 44.0%(11/25), respectively, the difference of which was not statistically significant(P>0.05).There was no significant correlation between the expression level of ANXA1, and gender, age, lesion length, T grading, N grading, M grading and clinical staging of ESCC patients(P>0.05).Univariate analysis showed that KPS score, tumor differentiation degree, length of lesion, T grading, N grading, M grading, clinical staging, chemoradiotherapy sensitivity and ANXA1 level were closely related to the prognosis of patients (P < 0.05 to P < 0.01).The multivariate analysis of Cox regression model showed that the KPS score, tumor differentiation degree, clinical staging, chemoradiotherapy sensitivity and ANXA1 level were the independent risk factors affecting the prognosis of ESCC patients(P < 0.05 to P < 0.01).The median total survival time in ANXA1 positive expression group was longer than that in negative expression group(P < 0.05).
ConclusionsThe expression of ANXA1 is not obviously correlated with chemoradiotherapy sensitivity, but is correlated with prognosis of ESCC.The negative expression of ANXA1 suggests the poor outcome of ESCC, and ANXA1 may be an independent risk factor influencing the prognosis of patients with ESCC.

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