【摘要】 目的 评估生长分化因子15(growth differentiation factor15,GDF15)在食管鳞状细胞癌组织中的表达水平、临床病理意义及预后，初步明确GDF15表达和患者放疗预后的关系。为食管癌放疗预后的预测和治疗提供一个可行的靶点。方法 选择新疆维吾尔自治区人民医院2020年1月至2023年5月行根治性放疗的食管鳞状细胞癌患者69例，放疗后2年内每3～6个月、2年后每6个月随访评估，收集患者相关临床数据。采用自动免疫组化技术检测食管癌患者病理标本中GDF15蛋白的表达，并采用卡方分析、COX比例风险模型等分析GDF15蛋白表达与食管鳞状细胞癌放疗患者近期疗效和预后的关系。结果 食管鳞状细胞癌患者GDF15高表达率为50.72%(35/69)。GDF15低表达组的食管鳞状细胞癌患者中位无病生存期为32个月；GDF15高表达组食管鳞状细胞癌患者中位无病生存期为14个月。69例患者中位总生存时间为24个月(16.3～31.7个月),37例(53.6%)患者死亡。GDF15高表达患者的总生存率、中位总生存期均低于GDF15低表达患者，差异均具有统计学意义(P<0.05)。其中，GDF15是影响食管鳞状细胞癌患者总生存的独立预后不良因素。结论 食管鳞状细胞癌组织中GDF15高表达患者相较低表达患者的近期疗效更差，疾病控制率、总生存期更低。GDF15高表达是食管鳞状细胞癌预后较差的独立危险因素。化疗、分期、GDF15表达为食管鳞状细胞癌患者总生存时间的影响因素(均P<0.05)。更多还原

【Abstract】 Objective To evaluate the expression level of growth differentiation factor 15(GDF15) in esophageal squamous cell carcinoma tissues, its clinicopathological significance and prognosis, and preliminarily clarify the relationship between GDF15 expression and the prognosis of patients after radiotherapy. To provide a feasible target for the prediction and treatment of the prognosis of esophageal cancer after radiotherapy. Methods A total of 69 patients with esophageal squamous cell carcinoma who received radical radiotherapy in the People’s Hospital of Xinjiang Uygur Autonomous Region from January 2020 to May 2023 were enrolled. The patients were followed up and evaluated every 3 months within two years after radiotherapy and every 6 months after two years, and the relevant clinical data of the patients were collected. The expression of GDF15 protein in the pathological specimens of patients with esophageal cancer was detected by automatic immunohistochemistry, and the relationship between the expression of GDF15 protein and the clinicopathological characteristics of esophageal squamous cell carcinoma was analyzed by chi-square analysis, cox regression model, etc. Results The high expression rate of GDF15 in patients with esophageal squamous cell carcinoma was 50.72%(35/69). For patients with esophageal squamous cell carcinoma in the low GDF15 expression group, the median disease-free survival was 32 months, while for patients with esophageal squamous cell carcinoma in the high GDF15 expression group, the median disease-free survival was 14 months. The median overall survival time of the 69 patients was 24 months(16.3 to 31.7 months), and 37 patients(53.6%) died. The overall survival rate and median overall survival time of patients with high GDF15 expression were lower than those of patients with low GDF15 expression, and the differences were statistically significant(P<0.05). Cox regression analysis showed that GDF15 was an independent prognostic factor affecting the overall survival of patients with esophageal squamous cell carcinoma. Conclusion In patients with esophageal squamous cell carcinoma, those with high expression of GDF15 in the tumor tissue have poorer short-term therapeutic effects compared to those with low expression. The disease control rate and overall survival time are lower in the former group. High expression of GDF15 is an independent risk factor for poor prognosis of esophageal squamous cell carcinoma. Chemotherapy, disease stage, and GDF15 expression are factors influencing the overall survival of patients with esophageal squamous cell carcinoma(both P<0.05).更多还原