中晚期食管癌AKR1C3、LEF1表达与放疗敏感性及预后的关系分析

目的研究中晚期食管癌醛固酮类还原酶家族1成员C3(AKR1C3)、淋巴细胞增强结合因子1(LEF1)表达与放疗敏感性及预后的关系。方法回顾性选择2017年1~12月期间唐山市人民医院收治的中晚期食管癌并接受调强放疗的患者作为研究对象。采用免疫组织化学检测食管癌中AKR1C3、LEF1的表达。放疗4周后,根据疗效评估结果分为放疗敏感组49例,放疗抵抗组25例。比较放疗敏感组与放疗抵抗组AKR1C3及LEF1表达、临床病理特征的差异。Logistics回归分析放疗敏感性影响因素。随访生存情况,比较不同AKR1C3、LEF1表达的食管癌患者预后差异。结果放疗抵抗组患者食管癌中AKR1C3及LEF1的阳性率、肿瘤最大横径≥4 cm及低未分化的患者比率分别为80.00%、84.00%、48.00%、56.00%,显著高于放疗敏感组(44.90%、48.98%、22.45%、30.61%),差异有统计学意义(P<0.05);经Logistics回归分析,AKR1C3、LEF1、肿瘤最大横径、分化程度是放疗敏感性的影响因素(P<0.05);经Kaplan-Meier曲线分析,AKR1C3及LEF1阳性表达的食管癌患者累积生存率低于AKR1C3、LEF1阴性表达的食管癌(P<0.05)。结论中晚期食管癌中AKR1C3、LEF1阳性表达与放疗抵抗及生存时间缩短有关。

Relationship between expression of AKR1C3,LEF1 and radiosensitivity,prognosis of advanced esophageal carcinoma.

Objective To study the relationship between the expression of AKR1C3,LEF1 and radiosensitivity,prognosis of advanced esophageal carcinoma.Methods Patients with advanced esophageal cancer diagnosed in Tangshan People's hospital from January to December 2017 and received intensity-modulated radiotherapy were selected as the research objects.The expression of AKR1C3 and LEF1 in esophageal cancer was detected by immunohistochemistry.After 4 weeks of radiotherapy,according to the results of the efficacy evaluation,they were divided into 49 cases in the radiotherapy sensitive group and 25 cases in the radiotherapy resistant group.The differences of AKR1C3 and LEF1 expression,clinicopathological features between the radiosensitive group and the radiotherapy resistant group were compared.The factors affecting the sensitivity of radiotherapy were analyzed by Logistics regression analysis.Survival was followed up.The prognosis of esophageal cancer patients with different AKR1C3 and LEF1 expressions were compared.Results The positive rates of AKR1C3 and LEF1,the proportion of tumor maximum transverse diameter≥4 cm and poor undifferentiation in the radiotherapy resistant group were 80.00%,84.00%,48.00%,and 56.00%,respectively,which were significantly higher than those in the radiotherapy sensitive group(44.90%,48.98%,22.45%,30.61%),the differences were statistically significant(P<0.05);by Logistic regression analysis,AKR1C3,LEF1,maximum transverse diameter of tumor and degree of differentiation were the influencing factors of radiosensitivity(P<0.05);by Kaplan Meier curve analysis,the cumulative survival rate of patients with AKR1C3 and LEF1 positive expression were significantly lower than those of patients with AKR1C3 and LEF1 negative expression(P<0.05).Conclusion The positive expression of AKR1C3 and LEF1 in advanced esophageal carcinoma relates to radiotherapy resistance and shorter survival time.