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食管癌在中国的发病率居于世界前列[1]。其中食管鳞癌的新发病例数约占世界新发食管癌总数的53%[2]。目前放疗是临床上食管癌综合治疗的关键手段之一,主要包括术前放疗、同步放化疗,但是食管癌病人的5年存活率仅为15%~25%[3]。大量饮酒和吸烟及其协同作用是食管癌的主要危险因素[1]。此外,肿瘤与炎症之间存在一定联系[4]。2005年,KIM等[5]首次正式报道了一种新的促炎症因子-自然杀伤细胞转录物4的基因产物,并命名为白细胞介素(interleukin,IL)-32。近年有研究[6-11]表明,IL-32表达的高低与肿瘤细胞凋亡、转移、侵袭存在一定关系,甚至抑制肿瘤生长,但这种关系在不同的肿瘤中存在差异,并且对预后也产生不同的影响。基于此,本研究通过免疫组织化学法检测95例食管鳞癌病人肿瘤组织,了解IL-32在食管鳞癌组织中的表达情况,探讨病人IL-32与放疗预后关系。现作报道。
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95例中IL-32低表达54例(56.84%),高表达41例(43.16%)。高表达组与低表达组病人性别、年龄、肿瘤位置、是否合并化疗差异均无统计学意义(P>0.05),而2组肿瘤分化程度差异有统计学意义(P < 0.05)(见图 1、表 1)。
临床特征 男 女 年龄/岁 肿瘤位置 分化程度 合并化疗 TNM分期/期 淋巴结转移 < 65 ≥65 胸上段 胸中段 胸下段 中-高 低 否 是 Ⅱ Ⅲ 阴性 阳性 低表达 40 14 15 39 14 25 15 29 25 24 30 25 29 33 21 高表达 26 15 16 25 5 17 19 31 10 16 25 24 17 26 15 χ2 1.25 1.34 4.56 4.8 0.28 1.4 0.05 P >0.05 >0.05 >0.05 < 0.05 >0.05 >0.05 >0.05 表 1 不同临床病理特征病人的IL-32表达(n)
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Kaplan-Meier生存分析显示,IL-32高表达组与IL-32低表达组预后差异有统计学意义(P < 0.05)(见图 2)。Cox多因素分析显示,合并化疗和IL-32高表达是食管鳞癌放疗病人预后的独立影响因素(P < 0.05)(见表 2)。
指标 B SE OR(95%CI) P 是否放化疗 0.452 0.216 0.637(0.417~0.972) < 0.05 分化程度 0.320 0.225 1.377(0.886~2.140) >0.05 性别 0.149 0.230 0.862(0.549~1.351) >0.05 年龄 0.242 0.237 1.273(0.800~2.026) >0.05 IL-32 0.486 0.235 0.615(0.388~0.974) < 0.05 表 2 食管鳞癌放疗病人预后影响因素的Cox回归分析
IL-32表达与食管鳞癌放疗后预后的关系
Relationship between IL-32 expression and prognosis of esophageal squamous cell carcinoma after radiotherapy
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摘要:
目的探讨白细胞介素(IL)-32在食管鳞癌组织中的表达及其与放疗后预后的关系。 方法回顾性分析食管鳞癌病人95例的临床资料,采用免疫组织化学法检测病人食管鳞癌组织中IL-32表达,按照IL-32表达情况分为IL-32高表达组41例和低表达组54例,比较2组病人相关临床特征及预后情况。 结果IL-32高表达组与低表达组病人性别、年龄、肿瘤位置、是否合并化疗差异均无统计学意义(P>0.05),而2组肿瘤分化程度差异有统计学意义(P < 0.05)。Kaplan-Meier生存分析显示,2组预后差异有统计学意义(P < 0.05)。Cox多因素分析显示,合并化疗和IL-32高表达是食管鳞癌放疗病人预后的独立影响因素(P < 0.05)。 结论IL-32高表达是中期食管鳞癌放疗后预后的独立影响因素。 Abstract:ObjectiveTo investigate the expression level of interleukin(IL)-32 in esophageal squamous cell carcinoma, and its relationship with the curative effects after radiotherapy. MethodsThe clinical data of 95 patients with esophageal squamous cell carcinoma were retrospectively analyzed.The expression levels of IL-32 in patients with esophageal squamous cell carcinoma were detected using immunohistochemistry.According to the expression level of IL-32, the patients were divided into the high expression group(41 cases) and low expression group(54 cases).The clinical features and prognosis were compared between two groups. ResultsThere was no statistical significance in the gender, age, tumor location and chemotherapy between two groups(P>0.05), while the difference of the tumor differentiation degree between two groups was statistically significant(P < 0.05).The results of Kaplan-Meier survival analysis showed that the difference of the prognosis between two groups was statistically significant(P < 0.05).The results of Cox multivariate analysis showed that the combined chemotherapy and high expression of IL-32 were the independent influencing factors of prognosis in patients with esophageal squamous cell carcinoma(P < 0.05). ConclusionsThe high expression of IL-32 is an independent risk factor of prognosis in patients with intermediate esophageal squamous cell carcinoma after radiotherapy. -
Key words:
- esophageal neoplasm /
- interleukin-32 /
- radiotherapy /
- prognosis
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表 1 不同临床病理特征病人的IL-32表达(n)
临床特征 男 女 年龄/岁 肿瘤位置 分化程度 合并化疗 TNM分期/期 淋巴结转移 < 65 ≥65 胸上段 胸中段 胸下段 中-高 低 否 是 Ⅱ Ⅲ 阴性 阳性 低表达 40 14 15 39 14 25 15 29 25 24 30 25 29 33 21 高表达 26 15 16 25 5 17 19 31 10 16 25 24 17 26 15 χ2 1.25 1.34 4.56 4.8 0.28 1.4 0.05 P >0.05 >0.05 >0.05 < 0.05 >0.05 >0.05 >0.05 表 2 食管鳞癌放疗病人预后影响因素的Cox回归分析
指标 B SE OR(95%CI) P 是否放化疗 0.452 0.216 0.637(0.417~0.972) < 0.05 分化程度 0.320 0.225 1.377(0.886~2.140) >0.05 性别 0.149 0.230 0.862(0.549~1.351) >0.05 年龄 0.242 0.237 1.273(0.800~2.026) >0.05 IL-32 0.486 0.235 0.615(0.388~0.974) < 0.05 -
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