| Purpose: To investigate clinical-biological factors which could predict the sensitivity to chemoradiotherapy of esophageal squmous cell carcinoma (ESCC).Methods: 181 patients with stage I–IV ESCC were evaluated. The cytokeratin 19 fragment antigen 21-1(CYFRA21-1), carcino-embryonic antigen (CEA), albumin(A) as well as haemoglobin(HB) concentration were measured before the initiation of chemoradiotherapy (CRT). The cutoff values of CYFRA21-1, CEA and A were defined as 3.4ng/ml, 3.3ng/ml, 3.5g/dL, respectively. HB was divided into three levels: <12.0g/dL, 12.0-14.0 g/dL, >14.0 g/dL. Clinical factors such as sex, age, tumor location, primary cancer length and TNM stage were also evaluated.Results: The effective rate (CR+PR) of the primary tumor estimated by CT was 60.71% (17/28) in patients with CEA high group while 92.54% (62/67) in patients with CEA low group (P = 0.000); 62.50% (20/32) in patients with CYFRA21-1 high group while 92.98% (53/57) in patients with CYFRA21-1 low group (P = 0.000). HB levels before and during CRT were also associated with the effectiveness (P = 0.005, 0.033,respectively). HB levels before CRT at 12.0-14.0g/dL were associated with the best effectiveness, followed by>14.0g/dL and<12.0g/dL (effective rates 88.89% versus 83.75%, 62.07%, respectively, P=0.005). HB levels during CRT also showed similar results (effective rates 87.80% versus 85.41%, 70.59%, respectively, P=0.033). Furtherly, according to numbers of the above risk factors, the sensitivity of CRT was higher in patients with 0-1 risk factors than those with 2-4 risk factors (P = 0.023).Conclusion: CYFRA21-1 and CEA as well as HB and their combination may be helpful in predicting the sensitivity to CRT of ESCC. However, the results should be further con?rmed in larger, more homogeneous studies. Objective: To study the relationship between expression of vascular endothelial growth factor (VEGF), epidermal growth factor receptor(EGFR), CD105 marked microvessel density (MVD) as well as clinicopathological characteristics and prognosis of esophageal squamous cell carcinoma (ESCC).Materials and methods: From Jaunary 2004 to Jaunary 2005, 50 patients with primary ESCC who were treated with operation in chest surgery in our hospital were included in our study. All patients weren't treated with radiotherapy or chemotherapy as well as others therapies. All specimens were fixed by 10% neutral formalin 12～16h and embedded by paraffin. Detecting the expression of the three biological markers in ESCC with SP immunohistochemical staining and analyzing by Statistical Package for the Social Science (SPSS)13.0. Then analyzing relationship between expression of three biological markers and clinicopathological characteristics and prognosis in ESCC.Results:1.The positive expression rate of VEGF was 60.00%(30/50). The expression of VEGF was closely related with depth of invasion,lymph node metastasis and clinical stage(P<0.05), but there was no significant difference between the expression of VEGF and the tumour locations, length of primary, macroscopical types, degree of differentiation as well as gender , age of patients (P>0.05).2.The positive expression rate of EGFR was 68.00% (34/50). The expression of EGFR was closely related with depth of invasion,lymph node metastasis and clinical stage(P<0.05), but there was no significant difference 3.CD105 marked MVD in the ESCC was 21.64±6.76. It was closely related with depth of invasion,lymph node metastasis and clinical stage(P<0.05), but there was no significant difference between CD105 marked MVD and the tumour locations, length of primary, macroscopical types, degree of differentiation as well as gender , age of patients (P>0.05)4.There was significant association between VEGF and EGFR expression. Both the two markers were associated with the angiogenesis of ESCC. Too high level of the two marker were related with poor prognosis.5. Kaplan-meier survival analysis and and Cox regression indicated that VEGF, EGFR, CD105 marked MVD were independent prognostic factors of ESCC.Conclusions:1.VEGF can promote angiogenesis, and also may promote invasion and metastasis of ESCC.VEGF was an useful biological predictor of progression of ESCC.2.The EGFR expression positivity is well related to the tumor angiogenesis,and the overexpressions of EGFR may predict of the poor prognosis of ESCC.3.CD105 marked MVD was closely related with depth of invasion,lymph node metastasis and clinical stage, too high CD105 marked MVD was associated with poor prognosis of ESCC.It would be a useful index for progression of ESCC.4.The VEGF expression was associated with EGFR, both the two markers were associated with angiogenesis and predict poor prognosis of ESCC.5. Kaplan-meier survival analysis and and Cox regression indicated that VEGF, EGFR, CD105 marked MVD were independent prognostic factors of ESCC. between the expression of EGFR and the tumour locations, length of primary, macroscopical types, degree of differentiation as well as gender , age of patients (P>0.05). |
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