MT-3基因表达在食管胸中段鳞癌中转移与预后的关系

目的 讨论MT-3基因在食管胸中段鳞癌中的表达、术后病理及患者预后指标中的关系.方法 对2009至2011年手术切除的96例食管胸中段鳞癌患者进行回顾性研究.使用免疫组织化学染色方法检测MT-3基因在肿瘤组织中的表达.使用χ2检验判断相关性、Kaplan-meier法进行生存分析、Log-rank检验判断生存差异性,采用Cox比例风险模型行多因素分析判断独立预后因素.结果 96例标本中,伴有MT-3基因阳性表达41例,占总例数的41.28%.食管胸中段鳞状细胞癌组织中MT-3的阴性表达与肿瘤的分化程度(P=0.029)、T分期(P=0.001)和淋巴结转移个数(P=0.005)相关.97例病例中3年生存率为45.9%,其中MT-3基因表达阴性患者为20.1%,MT-3基因表达阳性患者为52.6%.两者比较差异有统计学意义(P=0.01).Cox回归分析显示肿瘤分期以及MT-3基因阴性表达是食管胸中段癌术后的预后危险因素.结论 在食管胸中段癌中MT-3基因的表达降低,与肿瘤的分化程度,T分期和淋巴结转移个数相关.MT-3基因表达阳性较阴性表达患者的3年生存率明显提高.MT-3基因可能作为评估食管鳞状细胞癌手术预后的分子生物指标.

Expression of MT-3 gene in esophageal squamous cell carcinoma and its relationship with patient's prognosis

Objective To investigate the expression of MT-3 gene in esophageal squamous cell carcinoma and its relationship with postoperative pathology and patient's prognosis.Methods A retrospective study was performed in 96 patients with esophageal squamous cell carcinoma who received surgical resection in our hospital from 2009 to 2011.Immunohistochemical staining was used to detect the expression of MT-3 gene in tumor tissues.The χ2 test was used to evaluate the correlation, and Kaplan-meier method was used to analyze survival rate,moreover,Log-rank test was used to determine survival difference.The Cox regression analysis was performed to determine the independent prognostic risk factors.Results Among 96 specimens,there were 41 cases of positive expression of MT-3 gene,accounting for 41.28%.The negative expression of MT-3 in esophageal squamous cell carcinoma was closely correlated with tumor differentiation,T staging and lymph node metastasis (P<0.05 or P<0.01).Among 96 patients,the 3-year survival rate accounted for 45.9%,in which the patients with negative expression of MT-3 gene accounted for 20.1%,and the patients with positive expression of MT-3 gene accounted for 52.6%,there was a significant difference between them (P<0.05).Cox regression analysis showed that tumor differentiation degree,lymph node metastasis and negative expression of MT-3 gene were prognostic risk factors in patients with esophageal carcinoma in middle thoracic esophagus after surgery.Conclusion The expression levels of MT-3 gene are decreased in middle thoracic esophageal carcinoma,which is correlated with tumor differentiation degree, T staging and lymph node metastasis.The 3-year survival rate in patients with positive expression of MT-3 gene is significantly higher than that of patients with negative expression of MT-3 gene.Therefor MT-3 gene may be used as a molecular marker for evaluating the postoperative prognosis of patients with esophageal squamous cell carcinoma.