细胞角蛋白14与表皮钙黏蛋白在食管鳞癌中的表达及意义

目的探讨人食管鳞状细胞癌(ESCC)组织中细胞角蛋白14(CK14)和表皮钙黏蛋白(E-cadherin)的表达及临床意义。 方法回顾性分析2010年1月至2014年12月泰山医学院附属医院病理科存档食管石蜡包块160例，其中130例人食管鳞癌组织石蜡包块(观察组)及30例正常食管组织石蜡包块(对照组)，根据组织病理学分化程度、肿瘤TNM临床分期、肿瘤浸润深度分别分组，其中高中分化组104例，低分化组26例；Ⅰ、Ⅱ期51例，Ⅲ、Ⅳ期79例；有纤维膜浸润57例，无纤维膜浸润73例。应用免疫组织化学染色方法检测160例食管组织中CK14、E-cadherin的表达情况；统计分析食管鳞癌组织中CK14、E-cadherin的表达特征及其相互关系。 结果CK14的表达：(1)观察组和对照组CK14的表达强度比较，观察组(165.47±19.15)高于对照组(141.14±14.59)，差异具有统计学意义(t＝3.29，P<0.05)；(2)不同分化程度食管鳞癌组织CK14的表达强度比较，高中分化组(144.99±10.16)低于低分化组(169.25±20.11)，差异具有统计学意义(t＝1.72，P<0.05)；(3)不同TNM临床分期食管鳞癌组织中CK14表达强度比较，Ⅰ、Ⅱ期癌(140.91±15.43)低于Ⅲ、Ⅳ期癌(169.36±21.44)，差异具有统计学意义(t＝3.06，P<0.05)。E-Cadherin的表达：(1)观察组和对照组E-Cadherin的表达强度比较，观察组(156.25±16.08)低于对照组(169.23±15.21)，差异具有统计学意义(t＝1.71，P<0.05)；(2)不同分化程度食管鳞癌组织E-Cadherin的表达强度比较，高中分化组(160.48±7.72)高于低分化组(130.01±13.06)，差异具有统计学意义(t＝3.43，P<0.05)；(3)不同TNM分期食管鳞癌组织E-Cadherin的表达强度比较，在Ⅰ、Ⅱ期癌(158.86±6.88)高于Ⅲ、Ⅳ期癌(140.02±9.30)，差异具有统计学意义(t＝1.78，P<0.05)；(4)E-Cadherin表达强度与ESCC肿瘤浸润深度有关，未及纤维膜组(59/73)显著高于侵及纤维膜组(0/57)，差异具有统计学意义(χ²＝6.722，P<0.05)。观察组中CK14与E-Cadherin的阳性表达率比较，CK14(54.6%)高于E-Cadherin(45.4%)，差异无统计学意义(χ²＝1.756，P>0.05)。 结论CK14的过表达、E-Cadherin的表达缺失与食管鳞癌的发生及进展有关；CK14与E-cadherin可以作为检测食管鳞癌的独立诊断指标。CK14与E-cadherin可能成为食管鳞癌的新治疗靶点。

The expression and significance of cytokeratin 14 and E-cadherin in patients with esophageal squamous cell carcinoma

ObjectiveTo explore the expression and clinical significance of cytokeratin 14(CK14) and E-cadherin in patients with the esophageal squamous cell carcinoma(ESCC). MethodsOne hundred and sixty cases of esophageal paraffin blocks with 130 cases of human ESCC tissues (observation group) and 30 cases of normal esophageal tissues (control group) were collected.For observation group, according to histopathological differentiation degree, TNM clinical stage, tumor infiltration depth, 104 cases were divided to high differentiation group, while the rest 26 cases as poorly differentiated group; 51 cases were sort to Ⅰ, Ⅱ stage and 79 cases as Ⅲ, Ⅳ stage; fiber membrane infiltration were discovered in 57 cases, while 73 cases with no fiber membrane infiltration.The CK14 and E-cadherin expression were detected by the immunohistochemical staining method.The expression characteristics and the mutual relations of CK14 and E-cadherin in esophageal squamous carcinoma tissues were analyzed and compared. ResultsExpression of CK14: (1)the expression intensity of CK14 in observation group was 165.47±19.15, while it was 141.14±14.59 in control group, there was a significant difference between the two groups (t=3.29, P<0.05). (2)the expression intensities of CK14 was 144.99±10.16 in high differentiating group and 169.25±20.11 in poorly differentiating group, there was a significant difference between the two groups(t=1.72, P<0.05). (3)the expression intensities of CK14 in Ⅰ, Ⅱ phase and Ⅲ, Ⅳ phase were 140.91±15.43, 169.36±21.44, there was a significant difference between the two groups(t=3.06, P<0.05). Expression of E-cadherin: (1)expression intensity of E-cadherin in observation group was 156.25±15.21, while it was 169.23±16.08 in control group, there was a significant difference between the two groups(t=1.71, P<0.05). (2)differentiation intensity of E-cadherin was 160.48±7.72 in high differentiating group and 130.01±9.06 in poorly differentiating group, there was a significant difference between the two groups(t=3.43, P<0.05). (3)the expression intensities of E-cadherin in Ⅰ, Ⅱ phase and Ⅲ, Ⅳ phase were 158.86±6.88, 140.02±9.30, there was a significant difference between the two groups(t=1.78, P<0.05). (4)expression intensity of E-cadherin was associated with ESCC tumor infiltration depth, there were a significant differences between the two groups (χ²=6.722, P<0.05). In observation group, the positive expression rate of CK14(54.6%) was higher than that of the E-cadherin(45.4%), there was no statistically significant difference between the two group (χ²=1.76, P>1.76). ConclusionsThe higher expression of CK14 and the lower expression of E-cadherin are related to the occurrence and progress of esophageal squamous cell carcinomas.CK14 and E-cadherin can be independent diagnosis index of esophageal squamous cell carcinomas.CK14 and E-cadherin may become the new therapeutic targets for esophageal squamous carcinoma.