食管鳞癌组织Periostin和PI3K表达的预后意义

目的 Perisotin与磷脂酰肌醇3-激酶(phosphoinostitide 3-kinase,PI3K)在多种肿瘤组织高表达,参与细胞增殖、侵袭与转移.Perisotin与PI3K在食管鳞癌(esophageal squamous cell carcinoma,ESCC)表达的相关性及对ESCC患者的预后价值尚未完全阐明.本研究探讨Periostin和PI3K的表达与临床病理特征的关系,分析Periostin和PI3K相关性及预后价值.方法 收集安徽医科大学附属安徽省立医院2009-05-05 2011-06-03手术切除的局部晚期ESCC标本79例,应用免疫组化EnVision法检测Periostin和PI3K在ESCC组织与癌旁正常鳞状上皮的表达.结果 Periostin在ESCC组织中阳性表达率为73.4％ (58/79),明显高于癌旁正常鳞状上皮的39.2％ (31/79),x2=18.76,P＜0.001.PI3K在食管癌组织中阳性表达率为77.2％(61/79),明显高于癌旁正常鳞状上皮的36.7％ (29/79),x2=26.44,P＜0.001.Periostin蛋白高表达与ESCC组织的肿瘤分期、脉管侵犯、侵袭深度和淋巴结转移相关,P＜0.05;而PI3K蛋白高表达与肿瘤分期和浸润深度相关,P＜0.05.Periostin和PI3K蛋白的表达呈正相关关系,r=0.56,P＜0.001.Kaplan-Meier生存分析显示,Periostin和PI3K蛋白高表达的局部晚期ESCC患者的总生存时间(overall survival,OS)和无病生存(disease-free survival,DFS)均短于低表达者,P＜0.001.Cox回归分析表明,Periostin是影响局部晚期ESCC患者术后生存时间的独立危险因素.Periostin和PI3K同时高表达,或其中1个蛋白高表达,影响患者生存时间的危险度分别是2个蛋白均低表达的7.805和3.251倍,P值分别为0.002和0.054.结论 Periostin在ESCC中高表达与肿瘤分期、脉管侵犯、侵袭深度、淋巴结转移和预后有关,而PI3K蛋白高表达与肿瘤的浸润深度、分期及预后相关.Periostin 是ESCC患者预后的独立危险因素,联合检测Periostin和PI3K可能较单个蛋白更有预测患者生存时间的优势.

Expression of Periostin and PI3K proteins in locally advanced esophageal squamous cell carcinoma and their prognostic significance

OBJECTIVE Perisotin and phosphoinostitide 3-kinase (PI3K) are highly expressed in various tumor tissues,which are involved in cell proliferation,invasion and metastasis.The correlation of perisotin and PI3K expression in esophageal squamous cell carcinoma (ESCC) and their high expression on the value of prognosis in ESCC patients are seldom reported.The objective of this study was to explore the expression of Periostin and PI3K in locally advanced ESCC tissues and their correlation with clinicopathologic characteristics and to analyze relationship between perisotin and PI3K and their prognostic value in ESCC.METHODS Totally 79 locally advance ESCC patients who were received radical surgical resection in Anhui provincial hospital were collected from May 5th 2009 to June 3rd 2011.Immunohistochemistry staining EnVision was used to detect the expression of Periostin and PI3K in ESCC tissues and adjacent normal squamous epithelium.RESULTS The positive rate of Periostin was 73.4％ (58/79) and 39.2％(31/79) in ESCC and cancer-adjacent normal esophageal tissues,respectively,and there was significant difference (x2 =18.76,P＜0.001).The positive rate of PI3K was 77.2％ (61/79) and 36.7％ (29/79) in ESCC and cancer-adjacent normal esophageal tissues,respectively,and there was also significant difference (x2 =26.44,P＜0.001).High expression of Periostin protein was associated with tumor stage,vascular invasion,invasion depth and lymph node metastasis in ESCC tissue,while the high expressionof PI3K protein was correlated with tumor stage and depth of invasion.The expression of Periostin and PI3K protein waspositively correlated (r=0.56,P＜0.001).Kaplan-Meier survival analysis revealed that OS and DFS in patients withhigh expression of Periostin and PI3K protein were shorter than those with low expression,respectively (P＜0.001).Cox regression analysis showed that Periostin was a independent risk factor for postoperative survival time in patients withlocally advanced ESCC.Meanwhile,the risk of death for ESCC patients with high expression of Periostin and PI3K,highexpression of Periostin or PI3K was 7.805 times (P=0.002) and 3.251 times (P=0.054),respectively,for patientswith low expression of Periostin and PI3K.CONCLUSIONS The high expression of Periostin in ESCC is closely relatedwith tumor stage,vascular invasion,invasion depth,lymph node metastasis and prognosis,and the high expression ofPI3K protein is closely related with the depth of tumor invasion,stage and prognosis.Periostin is an independent prognostic factor for ESCC patients,and combined detection of Periostin and PI3K may be of more value in prediction of sur-vival time than single protein.