The Expression Of Serum Galectin-3in Esophageal Squamous Cell Carcinoma With Concurrent Radiochemotherapy Before Treatment And Clinical Research

Objective1. To explore the relationship between the clinical data and the serum Galectin-3expression in the esophageal squamous-cell carcinoma patients before treatment.2. To explore the relationship between the prognosis and the serum Galectin-3expression in the esophageal squamous-cell carcinoma patients before treatment.3. To conclude the curative effect and adverse reaction of the concurrentchemoradiotherapy of esophageal squamous-cell carcinoma.Methods1. Serum was collected from the patients with squamous-cell carcinoma whopresented and treated with concurrent chemoradiotherapy in Henan province tumorhospital radiotherapy from March2012to December2013. Serum from the patientswith concurrent chemoradiotherapy was sampled at the time of pre-treatment. Inaddition,39cases of serum were collected from the healthy persons who check up inHenan province tumor hospital.2. For patients with concurrent chemoradiotherapy comprised of cisplatin and5-fluorouracil. The radiotherapy dose of2Gy per day was initiated on day1ofchemotherapy and continued daily for5days per week for6weeks, for a total dose of60Gy. Two courses of chemotherapy were given during radiotherapy at6-weekintervals.3. The serum Galectin-3levels were measured with enzyme-linkedimmunosorbent assay, and to discuss the differences of the expression level betweenthe squamous-cell carcinoma patients and the healthy persons. 4. Evaluation of response and end pointsTo compare the serum Galectin-3expression levels in group of patients withesophageal squamous-cell carcinoma and healthy persons, and to explore differenceof the expression level. The acute radiation reactions were recorded during thetreatment, and the1year overall survival and progression-free survival rate for1yearwere observation in the group of esophageal squamous-cell carcinoma patients.To analysis the relationship between serum Galectin-3expression level ofesophageal squamous-cell carcinoma patients and the clinical stage, tumor site, tumorlength, lymph node metastasis and distant metastasis. To analysis the effects of theage, sex, clinical stage, tumor site and serum Galectin-3expression level to theoverall survival and progression-free survival.5. Statistical AnalysisAll statistical analyses were performed with SPSS software (17.0version).Unpaired t tests were used to compare the data between two groups.One-way analysis of variance was used to compare the data between multiple-unit.Using ROC curve determine the truncation point of Galectin3. Survival estimateswere calculated using the Kaplan-Meier method, and differences between thesurvivals were analyzed using the log-rank test．In multivariate analysis, the Coxproportional hazards model was used.Result1. Serum Galectin-3expression level of patients with esophagealsquamous-cell carcinoma was significantly higher than that of healthy(9.703±1.310ng/mL vs.7.858±1.017ng/mL). According to the ROC curve, the serumGalectin-3diagnostic boundary value of esophageal squamous-cell carcinoma is9.0ng/mL, sensitivity, specificity and accuracy were respectively69.0%,87.2%and86%. Serum Galectin-3expression level is influenced by lesion length. The1-yearprogress-free survival rate of high serum Galectin-3group(≥9.0ng/mL)wassignificantly lower than that of the low serum Galectin-3group (<9.0ng/mL)(47.4％vs.75.0％; P=0.037). The1-year progress-free survival rate and1-year overallsurvival rates were of stageⅠandⅡgroup was significantly higher than that of thestage Ⅲ, stage Ⅳ disease (100%vs.74.7%vs.22.9%; P=0.029and100%vs. 86.4%vs.47.8%; P=0.049). The variables were assessed by multivariate analysisusing the Cox proportional hazards model，and the results revealed that the clinicalstage and the serum Galectin-3were the independent prognosis factors ofprogress-free survival rate, and only the clinical stage was the independent prognosisfactor of overall survival rate.2. A complete response assessed by the result of spiral CT was noted in10of42patients(23.8％)with concurrent chemotaditherapy. Clinically, the most importanttoxic effect was myelosuppression. Grade3or4treatment associated side effectsoccurred in13patients(30.9％).Conclusion1. Serum galectin-3of patients with esophageal squamous-cell carcinomapre-treatment was significantly higher than that of healthy controls. Serum galectin-3levels in the patients with esophageal squamous-cell carcinoma were associated bythe lesion length.2. The expression level of serum galectin-3in the diagnosis of ESCC has acertain reference value. However, the practical application value in determinewhether invade adjacent organs of esophageal squamous-cell carcinoma need furtherresearch.3. In addition to the clinical stage, the expression of serum Galectin-3level ofpatients with esophageal squamous-cell carcinoma before treatment may become anindependent prognostic indicators.