The Study of Biological Parameters Associated with the Sensitivity to Chemoradiotherapy of ESCC
|School||Shandong Provincial Academy of Medical Sciences|
|Keywords||Esophageal squamous cell carcinoma Chemoradiotherapy Cytokeratin 19 fragment antigen 21-1 Carcinoembryonic antigen Albumin Hemoglobin Esophageal squamous cell carcinoma / pathology Immunohistochemistry Vascular endothelial growth factor Epidermal Growth Factor Receptor CD105 Microvessel density Prognosis|
Objective: To study the treatment of former serological tumor markers cytokeratin 19 fragment antigen 21-1 (cytokeratin 19 fragment antigen 21-1, CYFRA21-1), CEA (carcinoembryonic antigen, CEA), and albumin (albumin, A) , the hemoglobin (haematoglobin, HB), as well as the course of treatment, HB levels of esophageal squamous cell carcinoma (ESCC) put chemosensitivity. Materials and Methods: 181 cases of Phase I-IV primary ESCC patients enrolled, serum CYFRA21-1, CEA, A and HB level, the course of treatment to monitor A and HB levels measured before treatment. CYFRA21-1, CEA, A threshold were 3.4 ng / mL, 3.3 ng / mL, 3.5g/dl. HB divided into three levels: lt; 12.0g/dL, 12.0-14.0 g / dL, gt; 14.0 g / dL. Analysis CYFRA21-1 before treatment of CEA, A, HB, and the course of treatment A, HB expression level with radiotherapy and chemotherapy sensitivity relationship. Results: CT evaluation ESCC original foci have response rate (complete remission rate of partial remission rate) in the CEA high expression group to 60.71% (17/28) and the low expression group to 92.54% (62/67), the differences significant significantly (P = 0.000); CYFRA21-1 high expression group effective rate of 62.50% (20/32) in the low expression group was 92.98% (53/57), a statistically significant difference (P = 0.000). HB levels before treatment and radiotherapy and chemotherapy efficacy was significantly correlated (P = 0.005, 0.033). Treatment the former HB levels between 12.0-14.0g/dL between efficacy the best followed gt; 14.0g/dL efficacy worst group for lt; 12.0g/dL (efficiency of 88.89%, 83.75% , 62.07%, P = 0.005). HB level of efficacy in the treatment process shows similar results (efficiency were 87.80%, 85.41%, 70.59%, P = 0.033). Addition, we CYFRA21-1 gt; 3.4 ng / mL, CEA gt; 3.3 ng / mL, HB gt; 14.0 g / dL or lt; 12.0g/dL as radiotherapy and chemotherapy sensitivity risk factors. The analysis results show that: no or only one risk factor for radiation sensitivity was significantly higher than the 2-4 risk factors (P = 0.023). Conclusion: CYFRA21-1, CEA, HB, and three joint can predict ESCC radiotherapy and chemotherapy sensitivity. Nonetheless, the conclusions need to be a larger sample size and homogeneity argument. endothelial growth factor, VEGF), epidermal growth factor receptor (Epidermal Growth Factor Receptor, EGFR), the CD105 marker microvascular density (microvessel density, MVD) relationship with the prognosis of ESCC. MATERIALS AND METHODS: A retrospective analysis of 50 cases of radical esophageal resection clinical data in the the Thoracic Surgery row of our hospital from January 2004 to January 2005 year primary the ESCC cases of surgical specimens, all patients were not receiving chemotherapy, radiotherapy or other treatment for the tumor. All specimens were 10% neutral formalin fixed 12 16h the conventional drawn, dehydration, dip wax, paraffin melt-embedded serial sections grilled piece 2h, SP (Streptomyces avidin - expression of VEGF, EGFR, CD105 MVD marked by three biological indicators peroxidase complex) immunohistochemical staining method to detect specimens, and follow-up of their survival time, and then using the SPSS statistical package 13.0 statistical analysis three entries biological markers with clinical features and prognosis in ESCC. Results: 1.VEGF in the ESCC positive expression rate was 60.00% (30/50), and the level of depth of tumor invasion, lymph node metastasis, and clinical stage was a significant positive correlation (P lt; 0.05), but not with sex, age and tumor site, primary tumor length, macroscopic type and degree of differentiation is independent of (P gt; 0.05). 2.EGFR in ESCC tissue positive expression rate was 68.00% (34/50), EGFR expression and tumor depth of invasion, lymph node metastasis and clinical stage was a significant positive correlation (P lt; 0.05), but not with gender age and tumor site, primary tumor length, macroscopic type and degree of differentiation is independent of (P gt; 0.05). MVD marked by CD105 in ESCC tissues value of 21.64 ± 6.76, and with the depth of tumor invasion, lymph node metastasis and clinical stage was a significant positive correlation (P lt; 0.05), but not with gender, age and tumor site, the original lesion length, macroscopic type and histological grade (P gt; 0.05). ESCC inside of VEGF, EGFR is highly correlated with CD105 marker MVD MVD value of VEGF positive expression group 22.06 ± 6.80 was significantly higher than the negative expression MVD value 18.65 ± 6.54, the difference between the two groups with statistical significance (P lt; 0.01); ESCC within the EGFR and CD105 MVD marked by highly relevant of EGFR strongly positive and positive expression group MVD value of 22.89 ± 7.41 was significantly higher than the negative and weak positive expression of MVD was 16.52 ± 7.01, the difference between the two groups is statistically significant (P lt; 0.01). Related to the expression of VEGF and EGFR (rs = 0.300, P = 0.036), VEGF, EGFR and CD105-MVD marked by a high degree of correlation, the number of microvessels with VEGF, EGFR expression enhanced and increased. 5. Kaplan-meier survival analysis and COX regression show of VEGF, EGFR, MVD is to affect the independence of ESCC prognosis factors. The Conclusion: 1.VEGF promote ESCC angiogenesis, also may contribute to tumor invasion and metastasis, as one of the biological indicators reflect ESCC progress. 2.EGFR promote ESCC blood vessel formation, also may contribute to tumor invasion and metastasis, can be used as one of the biological indicators reflect ESCC progress. 3.CD105 mark MVD reaction ESCC angiogenesis in patients with tumor invasion and metastasis, the high MVD indicates a poor prognosis, as one of the biological indicators reflect esophageal progress. 4 esophageal cancer, the expression of VEGF and EGFR correlation between the expression can promote tumor angiogenesis. The ESCC of VEGF and EGFR expression levels of CD105 marker MVD is closely related to the high expression of VEGF and EGFR are harbingers of the tumor with poor prognosis. 5. Kaplan-meier survival analysis and COX regression show of VEGF, MVD of EGFR, CD105 marker is to affect the independence of ESCC prognosis factors.