The Expressions And Clinical Significance Of ARTN And GFRα3 In Esophagus Squamous Cell Carcinoma

Background: Esophagus squamous cell carcinoma(ESCC) is one of the most malignant tumors worldwide, Most ESCC patients are diagnosed at middle to late stages due to the lack of unique clinical symptoms.With morbidity and mortality ranked in the eighth and sixth respectively in the whole world. Despite the development of surgical techniques in combination with the use of radiotherapy and chemotherapy in the treatment become great advanced, the prognosis for ESCC patients remains poor. With a median survival of only one year. Hence.early diagnosis and treatment is crucial for improving survival and reducing deaths of ESCC patients.Goals: In order to know the role of proteins ARTN and GFRα3 in the progression of ESCC, we research the expressions of ARTN and GFRα3 in the ESCC tissues, normal tissues, high grade intraepithelial neoplasia and squamous cell carcinoma in situ respectively. And then analysis whether they have contact with the differentiation, clinical stage, lymphatic metastasis and survival prognostic significance of ESCC patients.Materials and methods: Materials : we Collect 114 excision samples from January 1, 2009 to September 30, 2010, which have been diagnosed as patients with ESCC by North Sichuan Medical College. Among all the samples, 24 cases are younger than 55 years(<55), while the rest 90 cases are older than or equal to 55 years(≥55); in terms of gender, 89 samples are from men and 25 samples are from women; In the aspect of tumor location, 21 cases are in the upper 1/3 of the esophagus, with 74 cases in the middle 1/3 of the esophagus and 19 cases in the lower 1/3 of the esophagus. Dividing the samples from view point of histological grade, 30 samples are high grade, while 55 samples are moderately differentiated and 29 samples are poorly differentiated;Concerning the clinical stage, TNM stage withⅠ-Ⅱare 30 cases, the rest Ⅲ- Ⅳstage are 84 cases. The last, we see about lymph node metastasis, there are 42 patients with lymph node metastasis and 72 patients do not have. All of patients include in this thesis without chemoradiotherapy before surgery. We then collect normal tissues, high grade intraepithelial neoplasia and squamous cell carcinoma in situ as contrast. methods: We determined the protein expression of two proteins namely ARTN and GFRα3 in normal tissues(with the distance over 5cm from the cancer) and ESCC by Western-blot and add detect the two proteins in high grade intraepithelial neoplasia and squamous cell carcinoma in situ by immunohistochemistry, respectively. We investigate whether the expression of the two proteins have relationship with clinical and pathological significance of ESCC, such as gender, age, tumor location, histological grade, TNM stage and lymph node metastasis,etc.Results: 1.The expression of protein ARTN in ESCC is higher than that of nomal tissues by Western-blot(p < 0.05);By immunohischemistry, the positive expression rate of protein ARTN in normal tissues, high grade intraepithelial neoplasia, in situ carcinoma tissue and ESCC is 0%(0/25),23.5%(4/17),80.7(90/114) respectively, there is significant difference between ESCC tissues and normal + high grade intraepithelial neoplasia tissues, in situ carcinoma tissue(p<0.05).2.Similarly,by Western-blot, compared with normal tissues, the expression of protein GFRα3 is much higher in ESCC tissues(p<0.05);In the aspect of inmmunohischemistry, the positive expression rate of protein GFRα3 in normal tissues, high grade intraepithelial neoplasia, in situ carcinoma tissue and ESCC is 0%(0/25), 29.4%(5/17), 76.8%(86/112), respectively, there is significant difference between ESCC tissues and normal + high grade intraepithelial neoplasia tissues, in situ carcinoma tissue(p<0.05).3. Both proteins ARTN and GFRα3 have different degree expression in highly, moderately and poorly differentiated ESCC. And the expression of protein GFRα3 was positively correlated with the expression of ARTN. Both of which were positively correlated with TNM stage and 5 years survival. While have no sense in age, gender, tumor location, degree of differentiation and lymph node metastasis, etc.Conclusions: The expression of GFRα3, especially when combined with ARTN expression, may have a role in the progression of ESCC. And we predict that they may be useful predictors of disease progression and outcome in ESCC.