The Esophageal NM23and KI67Expression And Its Relationship With Clinicopathological Features And Prognosis

Objective: KI67is a cell proliferation related genes. NM23is a tumorsuppressor gene. This paper mainly discusses the clinical significance of theexpression of ki67and nm23and the correlation between expression of Ki-67and nm23in human esophageal carcinoma.Methods: Selected123cases of esophageal paraffin-embeded samples forexperimental specimens from the Fourth of Hebei Medical University, January2000to November2000, KI67and NM23counts of123cases of esophagealwas detected by SP immunohistochemistry. Collected the data of clinicalpathology and follow-up, to analyze the relationship between KI67、NM23and clinicopathological factors by using statistical methods. The patients weregrouped according to the expression levels of various indicators and thesurvival analysis of esophageal cancer patients were done by using Kaplan-Mier method(log-rank test)and cox regression models(univariate andmultivariate analysis),and summarize the main factors impacted on survival.Result:1KI67、NM23determination:In the123cases of esophageal paraffin-embeded samples, the KI67positive group was68cases, the negative group was55cases, NM23positivegroup was79cases, the negative group was44cases. ki67positive rate withpathology and esophageal cancer lymph node hology metastasis, itsignificantly higher expression in the case with low degree of differentiation,lymph node metastasis and distant metastasis. nm23was significantly lowexpression in the cases with lymph node metastasis and distant metastasis; theexpression of nm23in esophageal cancer staging Ⅲ Ⅳ was significantlyhigher than stage Ⅰ, Ⅱ. The expression of nm23protein associated withlymph node metastasis, it expresses lower in the cases with lymph node metastasis than the cases without lymph node metastasis. Significantcorrelation between esophageal carcinoma of Ki-67protein highly expressednm23low expression. Conclusion: The high expression of Ki-67protein andlow expression of nm23protein may be associated with esophageal squamouscell carcinoma invasion and metastasis is closely related to the detection of theKi-67and nm23protein expression helps determine the prognosis of patients.2The correlation between the expression of KI67in esophageal carcinomawith clinicopathological and pathology factors.Count KI67expression of different clinical pathological condition inesophageal cancer tissue show: The expression of KI67in the group of lymphnode metastasis in esophageal cancer was significantaly higher than thatwithout lymph node metastasis (χ~2=4.940, p<0.05). KI67expression oftumor cell poorly differentiated group was significantly higher than that well-differentiated group (χ~2=12.863, p<0.01); tumor size≥3cm group wassignificantly higher than the tumor size<3cm group (χ~2=7.267，p<0.001);the expression of KI67among the lowerthoracic、the middle thoracic and theupper thoracic+cervical grouping were significantly different (χ~2=14.533，p<0.01) and not significant with the patient’s gender、age、pathologicaltype and the presence of distant metastasis.3The correlation between NM23expression and clinicopathological factorsin esophageal cancerNM23expression of different clinical pathological situations in esophagealcarcinoma shows: The expression of NM23in the group of lymph nodemetastasis in esophageal cancer was significantaly higher than that withoutlymph node metastasis (χ~2=22.088, p<0.01). NM23expression of tumorcell poorly differentiated group was significantly higher than that well-differentiated group (χ~2=13.769, p<0.01); lesion by T stage, the depth ofinvasion T3+T4group, NM23expression was significantly higher than Tis+T1+T2group (χ~2=14.432，p<0.01) and not significant with the patient’sgender、age、pathological type and the presence of distant metastasis.4Analysis of the relationship between ki67and nm23 High expression of nm23protein and low expression of Ki-67have nosignificant correlation with esophageal degree of differentiation, depth ofinvasion (p>0.05), but was significant correlated with the esophagealcancer tissue with lymph node metastasis, TNM stagethe difference (all p<0.05), suggesting that Ki-67and nm23proteins play an important role in theinvasion and metastasis in esophageal tissue differentiation.5Univariate analysis of prognosticSeeing from (table2-10), positive patients were51.5%、12.9%; the3-year,5year survival rates in lymph node negative patients69.8%,37.1%; Therewere significant differences in the statistical analysis of both (χ~2=26.730,p=0.000);5year survival rates in the middle-high group of tumor celldifferentiation andlow differentiation group were as follows:60.4%/40.5%,54.4%/37.9%(χ~2==5.064, p=0.024); the3-year,5-yearsurvival rates in the upper thoracic+cervical, middle thoracic and lowerthoracic were36.8%/6.1%,55.9%/39.8%,70.2%/55.2%(χ~2=12.460,p=0.002); the NM23-negative and positive group, the3-year,5yearsurvival rate were65%/50.3%,51.2%/27.7%(χ2=7.239, p=0.007);NM23/KI67(+/+) group、the NM23/KI67(-/-) group and NM23/KI67(-/+or+/-) group, The3-year,5-year survival rate were50.2%/20.8%,61.1%/50.3%,61.1%/47.3%(χ~2=13.906, p=0.001),log-ranktest (p<0.01), the3-year5-year survival rate among lymph nodemetastasis group, the tumor lesion location group, a singly detection ofNM23and combined detection of NM23/KI67, were significantly differentwith statistical significance; gender, age, tumor size, histologicaldifferentiation, pathological type, the depth of invasion and distantmetastasis impact on the prognosis of survival wad not statistically significant.7Cox multivariate analysis of prognosticThe influential factors on the prognosis of survival rate as follows:Lymphnode metastasis, pathologic type. The risk factors affecting overallsurvival of lymph node metastasis (B=1.014), pathological type (B=0.991). Conclusion:1Accompanied by lymph node metastasis,histological grade decreased, thedepth of invasion in esophageal tumor deepened, KI67and NM23positiveexpression was significantly higher. NM23and KI67was positivelycorrelated; no significant correlation between KI67and NM23.2Single prognostic factor analysis showed that:The level of NM23positive expression and joint detection of NM23andKI67positive expression had a significant effect on the prognosis of3-yearand5-year survival, and the joint detection of the NM23and KI67weresignificantly different, specific stronger. Obtained at the same time: Thelymph node metastasis,histological grade and site of lesion also have animpaction on the prognosis.3Cox multivariate analysis of prognostic showed thatThe influential risk factors for survival were lymph node metastasisandpathologic type. Lymph node metastasis is the highest risk factors for theprognosis of esophageal cancer patients. This study also showed that there isno affect on survival in the univariate analysis,, positive expression of NM23,and positive expression of combined detection of the NM23and KI67. Thismay be related to the small sample size of this study.