Twist在食管鳞癌中的表达及其对预后的影响

目的研究Twist在食管鳞癌组织中的表达及其与患者预后的关系。方法搜集112例有完整临床病理资料和随访记录的食管鳞癌标本,以及30例非肿瘤食管黏膜标本作为对照,使用Twist抗体进行免疫组化染色,根据表达情况分为阴性(-)、弱阳性( )、阳性( )和强阳性组( ),分析其与患者各项临床病理指标及预后的关系。结果Twist在食管鳞癌中表达显著高于非肿瘤食管黏膜(P<0.001);Twist表达与食管鳞癌术后发生远处转移呈正相关(P=0.001);Kaplan-Meier生存分析显示患者术后生存率随Twist表达增强显著下降(Log-rank检验P<0.001);Cox单因素风险比例模型显示肿瘤T分期、N分期、pTNM分期、远处转移和Twist表达强度是食管鳞癌患者术后死亡的危险因子(P<0.05);Cox多因素风险比例模型显示Twist表达强度(相对危险度为2.394,P<0.001)和肿瘤N分期是食管鳞癌患者术后死亡的独立危险因子。结论Twist蛋白表达增强与食管鳞癌的发生和远处转移有关,对患者术后生存时间有显著影响,Twist蛋白表达增高可能是食管鳞癌患者术后预后不良的重要指标。

Up-regulation of Twist predicts poor clinical outcome of patients with oesophageal squamons cell carcinoma

Objectives To identify the expression of Twist in oesophageal squamous cell carcinoma(ESCC) and analyze its correlation with patient survival.Methods Immunohistochemical staining using polyclonal Twist antibody were performed on paraffin embedded specimens from 112 patients with ESCC, and 30 specimens of non-neoplastic oesophageal epithelium were used as control. The staining intensity was stratified as absent(-), weak( ), moderate( ),and strong( ). Its association with clinicopathologic data and prognosis of ESCC was analyzed.Results The expression of Twist was significantly higher in ESCC than in non-neoplastic oesophageal epithelium (P<0.001). The Twist expression was positively related with distant metastasis after operation(P=0.001). Kaplan-Meier analysis showed that up-regulated expression of Twist was significantly associated with lower survival rates of patients after operation (log-rank, P<0.001). In addition, mono-variate analysis revealed that T/N classification, pTNM stage, distant metastasis and Twist expression were significantly correlated with mortality risk of patients after operation (P<0.05). By Multi-variate analysis, Twist expression (RR=2.394; P<0.001) and N classification were identified as the independent prognostic factors of patient survival.Conclusion Twist protein may play a vital role in ESCC carcinogenesis and distant metastasis. Intensive Twist immunostaining seems to be a useful marker in predicting patients with ESCC, who are likely to have an unfavourable clinical outcome.