| Background:China is a one of major high incidence of esophageal cancer, of which95%is squamous carcinoma. There is obvious difference of around70%for the European and American countries is adenocarcinoma. In the city, the morbidity of esophageal squamous cell carcinoma (ESCC) in malignant tumor is ranked fourth and the mortality is fifth; but in the countryside, the morbidity and mortality both are ranked fourth; the5years overall survival rate is still less than15%. In order to further improve the effectiveness of diagnosis and treatment of esophageal squamous carcinoma, it is urgent to find a simple, reliable prognostic marker to guide the clinical treatment strategy. In this study, we chose the preoperative neutrophils/lymphocyte ratio of peripheral blood, and the expression of DOG1protein in the tissue of esophageal squamous cell carcinoma (ESCC), to confirm their value in the prognostic assessment for esophageal squamous carcinoma.Methods:1, The first part of research was retrospectively analyzed475patients with esophageal squamous cell carcinomas underwent radical surgery resection in the cancer hospital of Chinese academy of medical sciences between January2007and December2008, were confirmed by postoperative pathology, and all patients did not receive radiation or chemotherapy before the operation. To analyze the relationship between the ratio of neutrophils/lymphocyte in preoperative peripheral blood with the prognosis of475patients;2, The second part of research was retrospectively analyzed162patients with esophageal squamous cell carcinomas underwent radical surgery resection in the cancer hospital of Chinese academy of medical sciences between January2006and December2008, were confirmed by postoperative pathology, and all patients with tissue specimen did not receive radiation or chemotherapy before the operation. To analyze the relationship between the DOG1protein expression of tissue chip by immunohistochemical staining with the prognosis of162patients, including162cases of esophageal squamous carcinoma tissues and some pairs of82cases of normal tissue adjacent to carcinoma.Results:1. The median NLR of475patients is1.77(0.53-11). To set2.5as a critical value, all patients were divided into high NLR group (2.5or higher,86cases) and low NLR group (<2.5,389cases). There are17.5%female in the low NLR group, significantly more than the2.1%of high NLR group (P=0.04). The overall5years survival rate of Low NLR group’s is48.6%, significantly longer than36%of the high NLR group (P=0.009). Single factor analysis showed that age, smoking history, T stage, N stage, postoperative patients with adjuvant therapy or NLR is significant correlated with the prognosis of patients (P<0.05). To make the multi-factor Cox regression analysis, we found that age, N stage, postoperative adjuvant therapy and NLR are the independent prognostic factors affected overall survival rate. In patients with no metastasis in lymph node of esophageal squamous cell carcinomas, the5-year survival rate of low NLR group is significantly higher than high NLR group (63.6%vs44.2%, P<0.001); In a group with lymph node metastasis, the same result was observed (33.5%vs27.9%, P=0.046).2. There are4cases (4.9%) of DOG1positive and7cases (8.5%) CCND1positive in82cases of normal tissue adjacent to carcinoma; There are35cases (21.6%) of DOG1positive and62cases (38.3%) CCND1positive in162cases of esophageal squamous carcinoma tissues. In esophageal squamous carcinoma tissues, the expression of DOG1and CCND1are significantly increase. The positive expression rate of DOG1are significantly higher in esophageal squamous carcinoma patients with the CCND1positive expression than the CCND1negative expression (P=0.001). The expression of DOG1or CCND1had no significant correlation with gender, age, smoking history, drinking history, the infiltration depth of primary tumor, whether with metastasis of lymph node, the differentiation degree of tumor, the location of primary tumor or other clinical and pathological factors. By single factor analysis, we can find that DOG1(P=0.007), CCND1(P=0.049), age (P=0.007), whether with metastasis of lymph node (P=0.001), and whether to accept postoperative adjuvant therapy (P=0.014) are the factors that influence patients’overall survival rate. By multi-factor analysis, DOG1expression, age, and with metastasis of lymph node are independent risk factors for the patients with esophageal squamous carcinoma are affected the postoperative survival of patients.Conclusion:According this research, we found that patients with radical resection of esophageal squamous carcinoma, preoperative peripheral blood NLR and DOG1expression in specimen of carcinoma are the independent risk factors to assess the prognosis of patient. |
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