粘着斑激酶在食管癌中表达的临床意义

目的探讨粘着斑激酶蛋白(focal adhesion k inase,FAK)的表达与食管癌发生、浸润转移及预后的关系。方法应用免疫组织化学En V ision法原位观察正常食管粘膜、单纯增生粘膜上皮、各级不典型增生上皮及癌组织中FAK蛋白的表达。结果正常食管粘膜未见FAK蛋白的表达。单纯增生粘膜上皮、不典型增生上皮及癌组织中FAK的阳性表达率分别为为10.0%、31.25%及62.5%,其中原位癌的阳性表达率为41.7%,浸润癌的阳性表达率为65.2%。无淋巴结转移者的阳性表达率为22.9%,有淋巴结转移者的阳性表达率为82.6%(P=0.0002)。FAK蛋白阳性表达率随肿瘤分化程度降低及浸润深度加深而增加(P<0.05,P<0.01)。FAK阳性表达者术后的3年和5年生存率分别为41.54%和38.38%,FAK阴性表达者的3年和5年生存率分别为89.66%和72.41%,两组3年及5年生存率的差别有显著性差异(P=0.0011和P=0.026)。结论FAK蛋白的表达与食管癌的发生,细胞分化,浸润,淋巴结转移及预后有关,FAK蛋白表达阳性的患者比表达阴性的患者预后差。

Clinical significance of focal adhesion kinase expression in esophageal carcinoma

Objective To explore the relationship between FAK expression and the carcinogenesis of epithelia,invasion,metastasis and prognosis of esophageal carcinoma.Methods The expression of FAK was examined in normal epithelia,simple hyperplastic epithelia,dysplasia and esophageal carcinoma by immunohistochemistry(EnVision) technique.Results Normal epithelia were negative for FAK expression.The positive expression rateof FAK was 10.0% in simple hyperplastic epithelia,31.25% in hyperplastic epithelia and 62.5% in esophageal carcinomas.The positive rate of FAK expression was significantly lower in situ carcinoma than in invasive carcinoma(P=0.026).Tumors with lymphatic metastasis showed significantly higher positive rate than those without lymphatic metastasis(P=0.0002).FAK overexpression significantly correlated with cell differentiation(P=0.0001) and depth of tumor invasion(P=0.018).Survival rates at 3 and 5 years were 41.54% and 38.38% respectively for positive staining group of FAK,however,that in those of negative FAK expression were 89.66% and 72.41% respectively.Significant difference existed between 3 and 5 yearsurvival rates of two groups.(P=0.0011 and P=0.026).Conclusion FAK overexpression in esophageal carcinoma was related to cell differentiation,tumour invasiveness,lymph node metastasis and prognosis.Patients who had FAK overexpression had a poorer prognosis than those without FAK expression.