食管鳞癌组织中结肠腺瘤息肉蛋白的表达及其临床意义

本研究探讨食管鳞状细胞癌组织及正常食管黏膜组织中结肠腺瘤息肉蛋白（APC）表达情况，并分析其与食管鳞状细胞癌临床病理及5年生存率的关系。方法：236例食管癌患者来自河南林州市。利用组织微阵列技术制作组织芯片，采用免疫组化ABC法，分析236例食管鳞癌组织和相应正常食管黏膜组织中APC蛋白的表达情况，探讨其与食管鳞癌患者年龄、性别、肿瘤细胞分化程度、淋巴结转移、TMN分期、大体分型和5年生存率的关系。结果：APC蛋白表达主要表现在胞浆中出现黄棕色颗粒，食管鳞癌组织中APC蛋白阳性表达率明显低于正常食管黏膜组织中的阳性表达率（32.2% vs 92.9%，P<0.05）；APC蛋白低表达与TMN分期相关（P=0.002），与年龄、性别、肿瘤细胞分化程度、淋巴结转移、和大体分型无关（P>0.05）；APC蛋白低表达食管鳞癌患者的5年生存率明显低于APC蛋白正常表达的食管鳞癌患者（P<0.001）。结论：APC基因表达缺失可能与食管鳞癌的发生、发展相关，导致5年生存率下降，因此上调APC可能是治疗食管鳞状细胞癌（ESCC）患者的新方向，检测APC可能为食管癌预后判断提供依据。

Expression and Clinical Significance of Adenomatous Polyposis Coli in Esophageal Squamous Cell Carcinoma Tissues

To investigate the role of adenomatous polyposis coli ( APC ) in esophageal squamous cell carcinoma ( ESCC ) development and progression and to explore the association of APC with the clinicopathological characteristics and five-year survival of ESCC patients. Methods: A total of 236 formalin-fixed, paraffin-embedded esophageal tumors and the corresponding normal epithelia were placed in a tissue microarray. Using tissue array and immunohistochemistry, the expression of APC was determined in the 236 ESCC tissues and their corresponding normal esophageal mucosal tissues. The correlation of APC expression with age, gender, tumor cell differentiation, lymph node metastasis, tumor-node-metastasis stage, general classification, and five-year survival rate of ESCC patients was analyzed. Results: APC protein expression was confined to the cytoplasm of ESCC cells. ESCC tissues had a significantly lower APC down-expression rate than the corresponding normal esophageal tissues ( 32.2% vs. 92.9%, P < 0.05 ). The APC down-expression was correlated with the tumor/metastasis/node stage ( P = 0.002 ), but not with the age, gender, tumor cell differentiation, lymph node metastasis, or general classification ( P > 0.05 ). Survival analyses showed that the abnormal expression of APC was associated with the five-year survival rate of patients with ESCC. Conclusion: APC down-expression may play an important role in the progression and development of ESCC, generally leading to a lower survival rate. Hence, APC has prognostic value, and is a potential therapeutic target of ESCC.