| ObjectiveTo study the relation of clinical indexes, serologic indexes, histologic indexes, metabolic imaging indexes and short-term effect, progression-free survival (PFS), overall survival (OS) in esophageal squamous cell carcinoma (ESCC) so as to seek the effective index to predict the radiotherapy effect.1.Materials and methods1.From Jan 2008 to Feb 2010,98 patients who were histologically proved ESCC were retrospectively analyzed. All of them were formerly accepted positron emission tomography/computed tomomgraphy before post-operative radiotherapy or definitive radiotherapy. Their 1,3,5-year survival rates were follow-uped. Clinical indexes included sex, age, pre-treatment level of hemoglobin, tumor position, clinical TNM stage, and degree of differentiation. Immunohistochemical indexes including p53,VEGF, and Glut-1 were analyzed with immunohistochemistry. Serologic indexes such as CYFRA21-1,CEA, CA19-9 and Metabolic imaging indexes included SUVmax, SUVmean, MTV, pre-treatment tumor length, and abnomalities on PET/CT. SPSS 13.0 statistic software was used to analyze the relation of all indexes above and long-term radiotherapy effect.2.From Jan 2009 to Apr 2010,31 patients who were histologically proved ESCC were prospectively analyzed. Their short-term radiotherapy effect was evaluated by clinical indexes, serologic indexes, and metabolic imaging indexes with SPSS 13.0 statistic software.Results1.When predicting long-term radiotherapy effect, sex, tumor position, pre-treatment CYFRA21-1,post-treatment CEA, pre-and post-treatment CA19-9 showed no relation with either median PFS or median OS (all P>0.05).There's no relation with age, pre-treatment CEA, post-treatment CYFRA21-1 and median OS,or pre-treatment level of hemoglobin with median PFS (all P>0.05).Age showed relation with median PFS(χ2=4.799, P=0.028), so did pretreatment level of hemoglobin and median OS (χ2 =3.950, P=0.047). Clinical TNM stage had positive relation with median PFS (χ2=6.174, P=0.046) and median OS (χ2=9.044, P=0.011) respectively, and so did degree of differentiation with median PFS (χ2=51.102, P=0.000),median OS (χ2=36.945, P=0.000). Positive rate of p53 was 51.0%. Positive p53 showed obvious correlation with median PFS (χ2 =54.113, P=0.000) and median OS (χ2=65.625, P=0.000). Positive rate of VEGF was 73.5%. Positive VEGF showed obvious correlation with median PFS (χ2= 20.870, P=0.000) and median OS (χ2=35.814, P=0.000).Positive rate of Glut-1 in the patients was 52.0%. Positive Glut-1 showed obvious correlation with median PFS (χ2=30.410, P=0.000) and median OS (χ2=35.153, P=0.000). The difference of CEA before and after radiotherapy showed obvious correlation with median PFS (χ2= 15.896, P=0.000) and median OS (χ2=11.275, P=0.001), so did the difference of CYFRA21-1 with median PFS (χ2=13.451, P=0.000) and median OS (χ2=9.527, P=0.002), and so did the difference of CA19-9 with median PFS (χ2=15.499, P= 0.000) and median OS (χ2=15.563, P=0.000). SUVmax of all the patients was 3.2～63.8, median 10.4. According to the cut-off of 10.4, SUVmax showed obvious correlation with median PFS (χ2=23.075, P=0.000) and median OS (χ2=19.887, P=0.000). SUVmean was 2～17.6, median 4.6. According to the cut-off of 4.6, SUVmean showed obvious correlation with median PFS (χ2=16.793, P=0.000) and median OS (χ2=41.821, P=0.000). MTV was 1.2～129.7, median 12.85. According to the cut-off of 12.85, MTV showed obvious correlation with median PFS (χ2= 24.560, P=0.000) and median OS (χ2=27.086, P=0.000). Abnormalities on PET/CT had obvious correlation with median PFS (χ2=30.436, P=0.000) and median OS (χ2=18.808, P=0.000), So did tumor length on PET/CT with median PFS (χ2=8.678, P=0.003) and median OS (χ2=8.994, P=0.003).Cox regression result showed that p53 (P=0.002, RR=4.883, 95%CI: 1.768～13.488), VEGF (P=0.034, RR=3.299, 95%CI: 1.096～9.933), SUVmean (P= 0.036, RR=1.398, 95%CI: 1.023～1.912), abnormalty on PET/CT (P=0.009, RR= 3.650, 95%CI:1.379～9.663) could predict the PFS, while p53 (P=0.000, RR= 14.459, 95%CI:4.146～50.425), Glut-1 (P=0.012, RR=3.232, 95%CI: 1.301～8.033), abnormalty on PET/CT (P=0.025, RR=3.740, 95%CI: 1.181～11.848) could predict the OS.2.When predicting short-term radiotherapy effect, sex, age, pre-treatment level of hemoglobin, tumor position, clinical TNM stage, degree of differentiation, pre-treatment level of CEA, CYFRA21-1 and CA19-9,SUVmax, SUVmean, abnomalities on PET all had no correlation. Pre-treatment tumor length showed obvious correlation with short-term radiotherapy effect(χ2=16.952,P=0.000), and MTV nearly had (χ2=3.770,P=0.052). Logistic regression showed that tumor length on PET/CT could well predict the short-term effect of radiotherapy for ESCCConclusionsWhen predicting the long-term effect of radiotherapy for esophageal squamous cell carcinoma, p53,VEGF, SUVmean and abnormalty on PET/CT may be used to forecast PFS,while p53,Glut-1 and abnormalty on PET/CT to OS.When predicting short-term effect, tumor length on PET/CT can be selected. |
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