CAJ | 학술논문

目的探讨趋化因子受体CCR7表达与胸中段食管鳞癌淋巴结转移及预后的相关性.方法回顾2003年6月至2005年6月手术治疗184例胸中段食管癌病例临床资料.采用免疫组化进行趋化因子受体CCR7检测,Kaplan-meier法进行生存分析、用Cox回归分析判定独立预后因素.结果 CCR7表达率Ⅱ期和Ⅲ期病例分别为70.3%和85.5%(x2=5.0,P=0.02);T2和T3病例分别为64.9%和80.9%(x2=5.4,P=0.01);有、无淋巴结转移病例分别为86.4%和65.0%(x2=10.8,P=0.00)两组差异均有统计学意义.有、无CCR7表达病例的5年生存率为26.3%和66.0%,差异有统计学意义(x2=23.7,P=0.00);其中T2病例分别为35.1%和70.0%(P=0.01);T3病例分别为22.4%和60.9%(P=0.00);pN0分别为28.8%和66.7%(p=0.00);pN1分别为14.3%和63.6%(P=0.00),两组差异亦均有统计学意义.Cox回归分析结果显示,T分类、N分类和CCR7表达是预后独立的危险因素.结论食管鳞癌不同的T、N分类中CCR7表达存在差别;CCR7表达者5年生存率降低;肿瘤的T分类、淋巴结转移和CCR7表达是独立的不利预后因素.
목적 탐토추화인자수체CCR7표체여흉중단식관린암림파결전이급예후적상관성.방법 회고2003년6월지2005년6월수술치료184례흉중단식관암병례림상자료.채용면역조화진행추화인자수체CCR7검측,Kaplan-meier법진행생존분석、용Cox회귀분석판정독립예후인소.결과 CCR7표체솔Ⅱ기화Ⅲ기병례분별위70.3%화85.5%(x2=5.0,P=0.02);T2화T3병례분별위64.9%화80.9%(x2=5.4,P=0.01);유、무림파결전이병례분별위86.4%화65.0%(x2=10.8,P=0.00)량조차이균유통계학의의.유、무CCR7표체병례적5년생존솔위26.3%화66.0%,차이유통계학의의(x2=23.7,P=0.00);기중T2병례분별위35.1%화70.0%(P=0.01);T3병례분별위22.4%화60.9%(P=0.00);pN0분별위28.8%화66.7%(p=0.00);pN1분별위14.3%화63.6%(P=0.00),량조차이역균유통계학의의.Cox회귀분석결과현시,T분류、N분류화CCR7표체시예후독립적위험인소.결론 식관린암불동적T、N분류중CCR7표체존재차별;CCR7표체자5년생존솔강저;종류적T분류、림파결전이화CCR7표체시독립적불리예후인소.
Objective To investigate the expression of chemokine receptor CCR7 and its correlation with lymph node metastasis and prognosis in esophageal cancer after esophagectomy. Methods One hundred and eighty-four patients with middle third squamous cell carcinoma of the esophagus were enrolled in this study. All patients underwent operation in Provincial Hospital Affiliated to Shandong University between June, 2003 and June, 2005. The expression of CCR7 was detected by immunohistochemistry. All statistic analyses were performed with SPSS 13.0 statistical software. According to the clinico-patho-logic factors, the difference of CCR7 expression was compared by x2 test. Kaplan-meier method was performed to calculate the survival rate, Cox regression multivariate analysis was performed to determine independent prognostic factors. Results The expression rate of CCR7 in stage Ⅰ , stage Ⅱ and stage Ⅲ patients was 25.0 % , 70.3% and 85.5% , respectively. The difference of CCR7 expression between stage Ⅱ and stageⅢ was statistically significant (x2 =5.0, P =0.02). The CCR7 expression rate in T1, T2 and T3 patients was 33.3% , 64.9% and 80.9% , respectively. The difference of CCR7 expression between T2and T3 was statistically significant (x2 =5.4, P =0.01). The level of expression of CCR7 in patients with lymph node metastasis was significantly higher than those without metastasis (x2 =10.8, P = 0.00). The 5-year survival rate instage Ⅰ , stage Ⅱand stage Ⅲ patients was 100.0% , 38. 3% and 22.4% , respectively. The 5-year survival rate in patients with CCR7 overexpression was significantly lower than those without CCR7 overexpression (x2 = 23.7, P = 0.00). The 5-year survival rate in T2, T3, NO and N1 patients with CCR7 overexpression was significantly lower than those without CCR7 overexpression The result of Cox analysis demonstrated that T , N and CCR7 overexpression were independent prognostic factors. Conclusion CCR7 expression was detected in esophageal squamous cell carcinoma and was found to be significantly associated with T stage,N stage and lymph node metastasis. The patients with CCR7 expression was significantly lower the 5-year survival rate than without CCR7 expression. T stage, lymph node metastasis and CCR7 expression were independent prognostic factors.