The Expression Of Claudin-4in Esophageal Squamous Ceil Carcinoma Of Middle Thoracic And Its Relationship With Clinical Pathology And Prognosis

Background&Objective:Esophageal squamous cell carcinoma(ESSC) is one of the most common neoplasms in china. Surigcal resection remains the primary treatment. But the5-year survival rate is only30%-50%, which is unpleasant. TNM staging is the basic indicator of prognosis without completely accuracy. So it is important to find a biomarker to evaluate the prognosis in order to guide the treatment after the sugery. It has been reported that the expression of claudin-4is aberrant in many sorts of carcinoma and the extent of its expression is correlative with the incursion and the prognosis of the patients. This study investigated the expression of claudin-4in esophagus squamous cell carcinoma by immunochemical streptavidin peroxidase(SP)methods and its relationship with clinicopathological significance and prognosis.Methods:A retrospective study was performed of93patients with mid-thoracic esophageal squamous carcinoma who accepted surgical treatment from Jan2003to Jan2006.The expression of claudin-4was examined by immunohistochemical streptavidin peroxidase(SP)methods. The survival rate was calculated by Kaplan-meier method and the difference was determined by the log-rank analyze. The cox regression analysis was performed to determine the independent risk factors for lymph-metastastic recurrence.Result:claudin-4protein expression was detected in42patients of93with positive rate of45.2%. The positive rate of claudin-4in T1,T2,T3andT4patients was separately66.7%、55.2%and30.3%with significant difference(p=0.01). The positive rate of claudin-4expression in N0and N1patients was separately59.6%and30.4%with significant difference(p=0.01). the positive rate of claudin-4expression in low-middle differentiation and high differentiation patients was separately26.1%and56.4%with significant difference(p=0.01). the5-year survival rate of patients with claudin-4expression and without claudin-4expression was separately50.0%and15.4%with significant difference(p=0.00). The cox regression analysis showed that the negative expression of claudin-4(p=0.009),T classification (p=0.049) and the lymphometastasis(p=0.004) were independent risk factors.Conclusion:the low expression of claudin-4protein was detected in esophagus squamous cell carcinoma and had a correlation with the differentiation, T classification and lmphometastasis. Cox regression analysis showed that the low expression of claudin-4protein is an independent risk factor and can be a biomarker of poor prognosis.