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目的 探讨放疗对食管癌ＰＣＮＡ蛋白表达的影响，指导临床选择有效治疗方案。方法在我院接受术前放疗及根治性食管癌切除术的９１ 例食管癌患者，前后两野垂直照射，肿瘤剂量３０～４０Ｇｙ１５ ～２０ 次３ ～４ 周。用免疫组化ＳＰ方法检测。结果 食管鳞癌呈１００ ％ ＰＣＮＡ 蛋白表达，放疗后高表达率７１－４％ 高于放疗前的５７－１ ％ ，Ｐ＝ ０－０４ ；疗后ＰＣＮＡ 高表达者较低表达者预后明显差，Ｐ＝ ０ ．０００１ ；比较同一病人放疗前、后ＰＣＮＡ蛋白表达，显示放疗后下降者、升高者和不变者的预后均有显著性差别，Ｐ＝ ０ ．００００１ 。结论 ①疗后ＰＣＮＡ蛋白表达升高，可能存在肿瘤细胞加速再增殖②ＰＣＮＡ高表达者预后很差；而放疗后与疗前相比，下降者生存最好，有可能成为评价预后指标。
Objective To investigate the effect of radiotherapy on the expression of PCNA protein in esophageal cancer and guide clinical selection of effective treatment. Methods A total of 91 patients with esophageal cancer who underwent preoperative radiotherapy and radical esophageal cancer resection were treated with vertical irradiation in the two fields. The tumor dose was 30-40 Gy for 15-20 times for 3 to 4 weeks. Detected by immunohistochemical SP method. Results The expression of PCNA protein was 100% in esophageal squamous cell carcinoma. The high expression rate was 71-4% after radiotherapy compared with 51-1% before radiotherapy, P = 0-04. The patients with high expression of PCNA after treatment had a poor prognosis. P= 0 . 0001; Comparing the expression of PCNA protein before and after radiotherapy in the same patient showed a significant difference in the prognosis of deceased, elevating, and invariable patients after radiotherapy, P = 0. 00001. Conclusions 1 The expression of PCNA protein increases after treatment, there may be tumor cells accelerated repopulation 2PCNA high expression is a poor prognosis; and after radiotherapy compared with pretreatment, the decline in the survival of the best, may become the evaluation of prognosis indicators.