食管鳞状细胞癌组织中uPA和PAI-1表达与浸润转移及预后的关系研究

目的探讨食管鳞状细胞癌组织中尿激酶型纤溶酶原激活物（uPA）和纤溶酶原激活物抑制剂1（PAI-1）基因表达及其对预后的影响。方法应用免疫组织化学方法检测uPA、PAI-1基因在80例食管鳞癌患者及20例食管癌旁正常组织中的表达，并应用Cox回归模型和Kaplan-Meier生存曲线检测分析其与患者预后的关系。结果在食管癌组织中uPA、PAI-1蛋白表达显著高于食管正常黏膜组织（P〈0．05）。uPA、PAI-1的表达与食管癌浸润深度、淋巴结转移有关（P〈0．05），但与年龄、民族无关。uPA和PAI-1的表达呈正相关（r=7．092，P〈0．05）。单因素Kaplan-Meier生存分析表明，10年总生存率为20％。食管癌uPA、PAI-1阳性表达组较阴性表达组有生存优势，但差异无统计学意义。Cox模型多因素分析表明，uPA、PAI-1不是影响生存期的独立因素，而肿瘤浸润深度和转移是影响生存期的独立因素。结论uPA、PAI-1蛋白表达与食管癌的发生发展有-定的关系，并可能成为判断预后的指标之一。

Study on the correlation of invasiveness,migration and prognostic between uPA and PAI-1 in esophageal squamous carcinoma

Objective To study on the correlation of invasiveness, migration and prognostic between uPA （urokinase-type plasminogen activator） and PAI-1 （plasminogen activator inhibitor type-l） in esophageal squamous carcinoma. Methods The expression of uPA and PAI-1 Protein in esophageal squamous cancer were detected by immunohistochemistry. The relationship between uPA and PAI-1 expression with ESCC prognosis was evaluated by COX regression model and Kaplan-Meier survival curve analysis. Results The positive rates of uPA and PAI-1 in esophageal squamous carcinoma were higher than those in normal esophageal tissue （P 〈0.05）. The expression of uPA and PAI-1 was correlated with invasion depth, lymph node metastasis （P 〈0.05）, but not with patientrs age, tumor size and nationality （P）0.05）. The expression of uPA was positively correlated with that of PAI-1 （P 〈0.05）. The ten-year overall survival ratefor all the patients was 20% （18/80）. It was known that the ten-year survival rate for patients with positive expression of uPA was higher than for patients with that of PAI-1 though the difference verified by Univariate survival analysis was not significant （P 〉0.05）. Conclusion It is suggested that the expression of uPA and PAI-1 play a certain role in ESCC progression. The expression of uPA and PAI-1 might be used as one of the prognostic marker in ESCC.