【摘要】 目的　探讨食管癌组织病理学特征和免疫蛋白表达的预后价值。方法　检测 97例原发性食管鳞癌手术切除标本 ,对肿瘤组织病理学特征和免疫蛋白表达与患者生存期的关系进行单因素KaplanMeier分析和多因素Cox分析。结果　单因素KaplanMeier分析显示 :低分化肿瘤、浸润性生长、肿瘤侵及外膜、间质无淋巴细胞浸润、淋巴结转移、高TNM分期、表皮生长因子受体 (EGFR)阳性表达和nm2 3阴性表达与患者生存率降低有关 (Log rank检验 ,P值均小于 0 .0 5 )。多因素Cox分析显示 :肿瘤生长方式 (RR =2 .0 0 0 )、淋巴细胞浸润的程度 (RR =0 .5 0 9)、TNM分期 (RR =1.733)、EGFR表达 (RR =1.812 )和c erbB 2表达 (RR =2 .36 4)是影响预后的主要因素 (P <0 .0 5 )。结论　在食管鳞癌中 ,肿瘤生长方式、淋巴细胞浸润的程度、EGFR和c erbB 2蛋白表达同TNM分期一样具有独立的预后价值。综合分析这些指标有助于识别肿瘤不同的生物学特性和准确判断患者的预后。更多还原

【Abstract】 Objective To investigate the prognostic value of various histopathological features and expression of immuno-phenotypes in esophageal squamous cell carcinoma (ESCC). Methods The tumor samples from 97 primary ESCC patients with potentially curative resection were evaluated for the following parameters: tumor size, grade of differentiation, pattern of invasion, depth of invasion, degree of lymphocyte infiltration, lymph node metastasis, TNM stage and p53, EGFR, c-erbB-2, nm23, cathepsin D protein expression. The prognostic impact of these parameters were analyzed by univariate and multivariate survival analyses. Results In the univariate Kaplan Meier analysis, poor differentiation, infiltrating growth pattern, invasion reaching adventitia, absent lymphocytic infiltration, lymph node metastasis, high staging, EGFR positive expression and nm23 negative expression were all associated with lower survival rate(Log-rank test, P <0.05, respectively). However, the multivariate Cox analysis demonstrated that only pattern of invasion( RR =2.000), degree of lymphocyte infiltration( RR =0.509), TNM stage( RR =1.733), EGFR expression( RR =1.812)and c-erbB-2 expression( RR =2.364)were significant prognostic factors( P <0.05, respectively). Conclusion For ESCC, the pattern of invasion, degree of lymphocyte infiltration, EGFR and c-erbB-2 protein expression had independent prognostic values as well as the TNM stage. Comprehensive analysis of these parameters can be helpful to identify biological behavior of ESCC and predict more accurately the prognosis of patients with ESCC.更多还原