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目的:探讨神经内分泌标志物突触素(synaptophysin,Syn)、神经细胞黏附分子56(neuronal cell adhesion molecules 56,CD56)、嗜铬粒蛋白A(chromogranin A,CgA)在92例食管小细胞癌(primary esophageal small cell carcinoma,PESC)中的表达,并分析其表达与患者临床病理特征和预后间关系。方法:采用免疫组织化学法(immunohistochemisty,IHC)检测PESC中CD56、CgA、Syn分子表达;logistic回归分析其与患者临床病理特征关系;Kaplan-Meier法、Cox多因素回归法进行单因素和多因素生存分析;Log-rank法比较各组间生存曲线差异。结果:食管下段癌组织中CgA阳性表达率高于食管中、上段(72.2%vs.41.1%vs.10.0%),且差异具有统计学意义(P=0.001)。CD56、CgA、Syn表达与患者性别(P=0.262,0.998,0.931)、年龄(P=0.250,0.998,0.703)、肿瘤浸润深度(P=0.253,0.997,0.061)、淋巴结有无转移(P=0.767,0.998,0.613)无关;N1、N0的PESC生存期差异无统计学意义(P=0.563);PESC混合鳞癌(HR=2.58;95%CI:1.11~5.98)及CgA阳性表达PESC(HR=1.87;95%CI:1.02~3.43)预后优于单纯PESC及CgA阴性表达患者。结论:CgA表达与PESC肿瘤部位有关;淋巴结有无转移不影响PESC患者预后;组织学类型及CgA表达是PESC患者预后独立影响因素。
Objective: To investigate the expression of neuroendocrine markers synaptophysin (Syn), neuronal cell adhesion molecules 56 (CD56) and chromogranin A (CgA) in 92 cases of esophageal small cell carcinoma primary esophageal small cell carcinoma (PESC)), and to analyze its relationship with clinicopathological features and prognosis. Methods: The expressions of CD56, CgA and Syn in PESC were detected by immunohistochemistry (IHC). The relationship between the expression of CD56, CgA and Syn in the PESC was analyzed by logistic regression. The Kaplan-Meier method and Cox regression were used to analyze the single and multifactorial factors Survival analysis; Log-rank method was used to compare the survival curves between groups. Results: The positive rate of CgA in the lower esophageal cancer tissue was higher than that in the upper and middle esophagus (72.2% vs. 41.1% vs. 10.0%), and the difference was statistically significant (P = 0.001). The expression of CD56, CgA, Syn was positively correlated with the patients’ gender (P = 0.262,0.998,0.931), age (P = 0.250,0.998,0.703), tumor depth (P = 0.253,0.997,0.061) 0.767,0.998,0.613). There was no significant difference in PESC survival between N1 and N0 (P = 0.563), PESC mixed squamous cell carcinoma (HR = 2.58; 95% CI: 1.11-5.98) = 1.87; 95% CI: 1.02 ~ 3.43) prognosis is better than simple PESC and CgA negative patients. Conclusion: The expression of CgA is related to the tumor site of PESC. The presence or absence of lymph node metastasis does not affect the prognosis of patients with PESC. The histological type and CgA expression are independent prognostic factors in patients with PESC.