| 1Background and objectivePathologic TNM staging of esophageal cancer (EC) is an important basis for theevaluation of the prognosis and treatment selection.But,through large-scale follow-upof EC patients,our laboratory found that in advanced (TNM III and stage IV) patientsurvival over10years is not uncommon.Obviously,simple TNM staging evaluating ofEC prognosis has some limitations, to further improve the TNM staging andmolecular typing for the correct evaluation of the biological characteristics of EC,treatment options and prognosis has important significance.To some extent,tumorlong diameter reflects the time and size of tumor growth, but the relationship of tumorlong diameter and TNM staging and survival in patients with lack of a large sample ofsystematic research.We are retrospectively analyzing the14612EC long diametervariation from1978to2007to explore the relationship of tumor long diameter andTNM staging and relevant risk factors on survival,and combining with our grouphaving been completed EC genome-wide association analysis results to understandthe relationship of the rs1varation and tumor long diameter and TNM relations anddetermines prognosis of EC, to provide the basis for EC clinical and moleculartyping. 2Materials and methods2.1PopulationAll14612EC patients information came from Henan Key Laboratory forEsophageal Cancer Research database,and these patients had been diagnosed asesophageal squamous cell esophageal from1978to2007and had radicalsurgery.Of the14,612patients,8,883were male (mean age56.41±9.04) and5,729female (mean age56.76±9.08), male/female ratio was1.55:1.2.2Clinical information to reviewOn the basis of epidemiological investigation, according to the treatment ofinformation provided by the patients, such as operative time,hospital,then wereviewed clinical information for each patient, including gender, diagnosised age,TNM stage, gross type, tumor size and family history.2.3Postoperative tumor long diameter measurementWe randomly selected100cases of EC patients from different hospitals, inaccordance with uniform standards for measurement. Specific measurement methodis: the resected esophageal specimens were cut along the non-tumor side, tiled fixedon the plate, fully and completely exposed to the tumor, mucosal side up, using aruler to measure the diameter of each tumor,and elected the longest tumor diameter astumor long diameter.The results of measurements comparing hospitals showed nosignificant difference. Tumor long diameters of14612EC patients were inaccordance with pathology report and statistically analyzed.2.4Follow-upOf the14,612EC patients,12,133who registered clearly home addresses orcontact numbers were applied for tracking the conditions of patients by telephone andhome interview follow-up. If patients died, the date of death and reasons should alsobe identified. The endpoint was death. Until Sep14,2013, of12,133EC patients,7,951were successfully followed up, with3,616alives and4,335deaths. 2.5Blood sample collection,DNA extraction and genotypingWith the permission of each EC patient,3~5ml venous blood was took intoEDTAK2vacuum tube. Genomic DNA was extracted and the concentration wasmeasured, then electrophoresis, and normalized to15~25ng/μl. By using Taqman florescence quantitative technology conducted genotyping for the SNPs loci.2.6Statistical analysisSPSS17.0was used for data analysis: Count data using x2test; measurement datawith the rank-sum test; tumor long diameter relationship with gender,age and clinicalpathology using Analysis of variance; correlation analysis using Spearman’s rankcorrelation; The survival rate was calculated Kaplan-Meier method; Log-rank testgenotype influence on the prognosis; influencing factors using Cox proportionalhazards regression model to analyze the prognosis of patients with EC. Test level:alpha=0.05.3Results3.1Clinicopathologic characteristicsWith the increase of years, tumor long diameter is significantly reduced from1978to2007(P<0.05); with the deepening of tumor infiltration, tumor long diameteris gradually increasing (P<0.05); tumor long diameter was positively correlated withtumor volume,T staging and TNM staging.3.2Survival follow-upUnivariate survival analysis showed that gender,tumor location, tumor diameter,tumor volume, gross types,T staging, N staging and TNM staging affected prognosis(P<0.05);Multivariate survival analysis suggested that T staging, N staging wereindependent factors of long-time survival except for tumor diameter (HR 3.3The relationship of the SNP locus rs1polymorphism andesophageal cancer clinicopathologic and survivalHardy-Weinberg equilibrium test showed the SNP locus rs1genotype in thispopulation was genetic equilibrium distribution (P=0.33). rs1expressed differentgenotypes in T staging. However, rs1with age at diagnosis, gender, high and lowareas,tumor location, tumor long diameter, tumor volume, gross types, degree ofdifferentiation, lymph node metastasis, TNM staging and survival time were notcorrelated (P>0.05). the genotypes of rs1did not have influence on survivalsignificantly (χ2=1.199,P>0.05).4Conclusions4.1With the increase of years,tumor long diameter had been significantly reducedfrom1978to2007;4.2As the tumor long diameter increased, TNM staging tended to be more seriousand the postoperative survival was poorer;4.3The genotypes of rs1was associated with T staging. |
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