The Expression And Of Prostaglandin E Receptor2 And EGFR In Esophageal Squamous Cell Carcinoma And Associa Tion With Prognosis

Objective: To analyze the role of NLR/PLR in the ESCC patients with tumor located at the middle or low parts of the esophagus. To find the relationship between EP2 and EGFR in ESCC patients, and analysis they are role in judge prognosis.Methods: 317 patients with ESCC who underwent attempted curative esophagectomy were analyzed, checked the blood routine examination in a week preoperative. Work out the NLR and PLR by collected the neutrophils count, platelet count and lymphocyte count. We examined the expression of EP2 and EGFR in ESCC tissues of tumor, the junction of tumor and normal and the normal in anastomosis by immunohistochemical staining, and analysis the relationship between the two marks. Further more, analysis the role of EP2 and EGFR in ESCC tissues of tumor, the junction of tumor and normal and the normal in anastomosis in DFS and OS.Results: There were 317 patients, ratio of man and woman was 5.5:1, and the mean age was 60 years(range from 30 to 77 years). 1. The median NLR and PLR were 3.3 and 147 separately. The cut-off value of NLR and PLR was defined as 3.3 and 150. Of the 317 patients with ESCC, 157 and 98 patients had NLR and PLR levels higher than the cut-off value(NLR>3.3, PLR>150), respectively. Univariate analysis found the elevated NLR and PLR were important in DFS and OS of ESCC patients, and further analysis found PLR was an independent factor of OS, with statistically significant difference(P=0.010). 2. The express of EP2 were declined from tumor, the junction of tumor and normal to the normal in anastomosis, and the positive rate were 68.5%(217 cases)、15.8%(50 cases)、6.3%(20 cases), respectively(P<0.001). The positive rate of EGFR in tumor, the junction of tumor and normal to the normal in anastomosis were 89.6%(284 cases)、30.9%(98 cases)、6.6%(21 cases), the expression wasdeclined as EP2, with statistically significant difference(P<0.001). 3. There had some relationship between the express of EP2 and EGFR in the tissues of tumor and the junction of tumor(P<0.001), but in the normal tissues was not find the correlation in EP2 and EGFR(P>0.05). 4. The median DFS was 19.2 months and the median OS was 34.1 months of 317 ESCC. The median DFS was 17.0 months and 32.0 months in EP2 positive and negative express in tumor tissues, the differences are statistically significant(P<0.001), The median OS was 29.5 months and 66.5 months in EP2 positive and negative express in tumor tissues(P<0.001). The median DFS was 10.8 months and 21.3 months in EP2 positive and negative express in the junction of tumor and normal tissues(P<0.001), The median OS was 21.9 months and 41.6 months in EP2 positive and negative express in the junction of tumor and normal tissues(P<0.001). In normal tissues, the median DFS of the patients with EP2 expressed and non-expressed was 10.4 months and 20.4 months, with statistically significant difference(P=0.036), and the median OS was 13.8 months and 39.0 months in the group of EP2 positive and negative(P=0.031) 5. The median DFS was 18.0 months and 62.0 months in EGFR positive and negative express in tumor tissues, the differences are statistically significant(P=0.003), The median OS was 31.9 months and 115.2 months in EGFR positive and negative express in tumor tissues(P<0.001). The median DFS was 10.8 months and 20.4 months in EGFR positive and negative express in the junction of tumor and normal tissues(P=0.180), and median OS was 29.5 months and 39.5 months in EGFR positive and negative express in the junction of tumor and normal tissues, with no statistically significant difference(P>0.05). In normal tissues, the median DFS of the patients with EGFR expressed and non-expressed was 9.7 months and 20.0 months, with statistically significant difference(P=0.022), and the median OS was 15.9 months and 38.6 months in the group of EP2 positive and negative, with no statistically significant difference(P>0.05).Conclusion: Elevated NLR and PLR were common in ESCC, and there often indicate the poor prognosis. The expression of EP2 and EGFR were high in tumor tissues of ESCC, and the positive expression rate of the two markers had positive correlation.