| Esophageal carcinoma(EC) is one of the most common malignancies,ranked fourth in the global incidence of esophageal cancer.Esophageal cancer has become one of the main causes of death tumor in China.At this stage it is not clear exactly the cause of esophageal cancer, most patients are in the middle and late stage when they get treatment,the 5 year survival rate is only about 25%.But if patients can get surgical operation in early stage,5-year survival rates will increase to 90%.At present exploreing the pathogenesis of esophageal cancer in the early stage, it has become one of the main research directions of clinical esophageal cancer.But the pathogenesis of esophageal carcinoma is no breakthrough in the clinical and basic research. With the improvement of molecular biology technology research,it has been confirmed in head and neck squamous cell carcinoma, lung cancer, oral cancer,colorectal cancer include all epithelial tumor of esophageal squamous cell carcinoma, there are a representative of the early lesions of "field cancerization" phenomenon.Aquaporin-3 is a member of the AQPs family, it has the common characteristics of the protein family genes.AQP3 play an important role in differentiation of the tumor proliferationand,invasion metastasis.At present, for esophageal squamous cell research from domestic rare "field cancerization" perspective to investigate the pathogenesis of early esophageal cancer,squamous cell carcinoma of the esophagus in particular the lack of regional cancerous aquaporin-3(AQP-3) expression and clinical studies of systemic understanding.Recent studies showed that,AQP3 expression has been shown to be associated with proliferation,differentiation, invasion, metastasis and survival prognosis of various cancers.According to the reports,the expression of AQP-3 was different in different tissues of esophageal squamous cell carcinoma type.It has been check out specimens which own "field cancerization" in esophageal squamous cell carcinoma though using Lugol's and HE staining.we applied real-time PCR and western-blot techniques to measure the mRNA expression different levels of AQP3 genes in normal esophageal epithelium areas and esophageal Squamous Cell Carcinoma areas and cancerous areas.It has been analyzed the correlation of the gene expression and the factor.Combined with postoperative follow-up systems to assess the reationship between the AQP3 gene expression level,clinical prognostic factors and thesurvival time.To provide a new way for the early pathogenesis of esophageal squamous cell carcinoma.Objective According to the basic theory of esophageal squamous cell carcinoma "field cancerization", using Lugol's staining and hematoxylin and eosin chemical staining method check out the "field cancerization tissue" of esophageal squamous cell carcinoma, which Lugol's staining was positive close to the primary tumor, and the regiosl' pathological phenotypes are normal. Using real-time PCR and Western blot technique detecte AQP3 expression in normal esophageal epithelial tissue, esophageal squamous cell carcinoma tissue and cancerous tissue,the result show that AQP3 expression in different esophageal tissue has significant differences. Investigating the relationship between AQP3 expression and esophageal squamous cell survival through combining with clinical prognostic factors.preliminary understanding differences in AQP3 expression in early esophageal cancer.Method(1)The subject collected 102 esophageal cancer patients who hospitalized in Department thoracic surgery of Gansu Provincial People s Hospital,from year 2010 to 2015. Lugol's iodine solution was spraied onto the mucosas of the epithelium of esophagus immediately after esophagectomy. In all 65 cases of lugol-unstained lesions were resected carefully.routine staining with hematoxylin and eosin was carried out and pathological diagnosis of these lesions were obtained.(2) The expression of AQP3 gene in 65 ESCC patients with lugol-unstained epithelium with normal pathological phenotype lesions were detected with western-blot and RT-PCR.(3) We collected 65 cases esophageal cancer patients' s clinical information according medical record query and return visit system. Statistical analysis:The Kaplan-Meier method the related independent factors of survival; Log-Rank test was used to compare the survival difference between the survival curves were drawn; Cox regression analysis to determine the independent factors affecting the prognosis of esophageal squamous cell carcinoma, with ?=0.05 for the difference was statistically significant Result1.Preliminary screening of esophageal squamous cell carcinoma 's field cancerization by Lugol's staining and HE chemical staining method.The lugol-unstained epithelium with normal pathological phenotype confirm the conceptof “field cancernation”. It might be the precursor of ESCC.2.The Relationship between AQP3 mRNA,protein and Esophageal CancerThe results show that AQP3 mRNA,protein expression in esophageal Mucosa, field cancerization areas, esophageal squamous cell carcinoma tissue. has significant differences(p<0.05).The high expression of AQP3 mRNA was associated with man,family history,tumor metastasis,well differentiation,infiltrating depth, tumor size.The trends are consistent with AQP3 mRNA expression3. survival analysisKaplan-Meier survival analysis showed that the survival of esophageal squamous cell carcinoma has associated with gender, family history,lymph node metastasis, depth of invasion, differentiation, tumor morphology, AQP3 mRNA and protein expression.Cox regression model showed that the independent prognostic factors of gender, lymph node metastasis, degree of differentiation, depth of invasion and AQP3 mRNA and protein expression.ConclusionIn this paper first screening of esophageal field cancerization areas tissue and cancerous region, detecting the differential expression of AQP3 gene in esophageal field cancerization areas verified from different aspects of genome, protein group etc,combined with clinical pathological index correlation analysis between AQP3 expression and survival of esophageal squamous cell carcinoma, so as to make people have a better understanding of the nature of field cancerization, provides a new research direction for the upstream target for esophageal squamous cell carcinoma pathogenesis. |
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