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目的探讨食管癌组织中的SEL 1L蛋白、Smad 4蛋白的表达与食管癌生物学行为的相关性。方法应用免疫组织化学S-P法检测90例手术切除的食管鳞状细胞癌,35例距癌灶边缘5cm以上切缘的正常黏膜,60例癌旁黏膜及20例内窥镜活检的食管鳞状上皮不典型增生组织中SEL 1L蛋白和Smad4蛋白的表达。结果(1)SEL 1L蛋白在食管鳞状细胞癌的表达阳性率为87.8%,在食管鳞状上皮不典型增生中的表达阳性率为90.0%,分别较食管正常黏膜(14.3%)和癌旁黏膜(13.3%)高(P<0.01)。SEL 1L蛋白表达与患者性别、年龄和肿瘤的位置、大小、分化程度、浸润深度、淋巴结转移及临床分期均无明显相关性(P>0.05)。(2)Smad 4蛋白在食管鳞状细胞癌的表达阳性率为48.9%,较食管正常黏膜(88.6%)、癌旁黏膜(83.3%)和食管鳞状上皮不典型增生(70.0%)低(P<0.01);临床分期ⅡB+Ⅲ期和有淋巴结转移的食管鳞状细胞癌组织Smad 4蛋白的阳性率明显低于临床分期Ⅰ+ⅡA期和无淋巴结转移的食管鳞状细胞癌组织(P<0.05);Smad 4蛋白的表达与肿瘤组织分化程度呈正相关(r=0.347,P<0.01),而与患者性别、年龄和肿瘤的位置、大小、浸润深度无明显相关性(P>0.05)。(3)食管鳞状细胞癌组织中SEL 1L蛋白和Smad 4蛋白的表达呈明显负相关(r=-0.314,P<0.01)。结论(1)SEL 1L蛋白过表达可能是食管鳞状细胞癌发生的早期表现,SEL 1L蛋白的检测可作为识别食管癌高风险患者的生物学标记物。(2)Smad 4蛋白的低表达在食管癌的发展及侵袭转移中具有重要作用。(3)SEL 1L蛋白和Smad 4蛋白在食管癌的发生发展过程中具有协同作用;联合检测食管癌中SEL 1L蛋白和Smad 4蛋白的表达,比单一检测一种蛋白对评估食管癌的发生、发展及预后更具有意义,也为临床治疗食管癌提供了一条新的思路。
Objective To investigate the correlation between the expression of SEL 1 L protein and Smad 4 protein in esophageal cancer and their biological behavior. Methods 90 cases of esophageal squamous cell carcinoma were resected by immunohistochemical SP method. The normal mucosa of 35 cases with margin of more than 5cm from the edge of the lesion, 60 cases of adjacent mucosa and 20 cases of endoscopic biopsy esophageal squamous cell carcinoma Expression of SEL 1 L protein and Smad 4 protein in atypical hyperplasia tissues. Results (1) The positive rate of SEL1L protein expression in esophageal squamous cell carcinoma was 87.8%, while it was 90.0% in esophageal squamous cell dysplasia, which was significantly higher than that in normal esophageal mucosa (14.3%) and adjacent Mucosa (13.3%) was high (P <0.01). There was no significant correlation between SEL1L protein expression and patient’s gender, age, tumor location, size, degree of differentiation, depth of invasion, lymph node metastasis and clinical stage (P> 0.05). (2) The positive expression rate of Smad 4 protein in esophageal squamous cell carcinoma was 48.9%, which was lower than that in esophageal normal mucosa (88.6%), paracancer mucosa (83.3%) and esophageal squamous cell dysplasia (70.0%) P <0.01). The positive rate of Smad 4 protein in stage ⅡB + Ⅲ and esophageal squamous cell carcinoma with lymph node metastasis was significantly lower than that in clinical stage Ⅰ + ⅡA and without esophageal squamous cell carcinoma (P <0.05). There was a positive correlation between the expression of Smad 4 protein and tumor differentiation (r = 0.347, P <0.01), but not with the gender, age, tumor location, size and depth of invasion . (3) The expression of SEL 1 L protein and Smad 4 protein in esophageal squamous cell carcinoma was negatively correlated (r = -0.314, P <0.01). Conclusion (1) SEL1L protein overexpression may be an early manifestation of esophageal squamous cell carcinoma. The detection of SEL1L protein may be used as a biomarker to identify high risk esophageal cancer patients. (2) The low expression of Smad 4 protein plays an important role in the development of esophageal cancer and its invasion and metastasis. (3) SEL1L protein and Smad4 protein have a synergistic effect in the development and progression of esophageal cancer; Combined detection of the expression of SEL1L protein and Smad4 protein in esophageal cancer, compared with the single detection of a protein to evaluate the occurrence of esophageal cancer, Development and prognosis of more meaningful, but also for clinical treatment of esophageal cancer provides a new way of thinking.