Expression And Clinical Significance Of REGIα In Esophageal Squamous Cell Carcinoma

OBJECTIVE This study aimed to preliminarily evaluate the prognosis value of the expression of REG Iα and its associationwith the clinical pathological features in esophageal squamous cell carcinoma(ESCC). Further, we investigated the relationship between the expression of REG Iα and sensitivity of adjuvant chemotherapy in ESCC.METHODS We retrospectively analysis the clinical data of ESCC patients after radical surgery with or without adjuvant chemotherapy, who received treatment in Tianjin Medical University Cancer Institute and Hospital from January 1, 2008,to December 31, 2010. The expression of REG Iα was detected by immunohistochemical staining S-P with pathological tissues in ESCC patients. The relationship between REG Iα and clinical pathological features including the original site of tumor, tumor infiltration depth(T stage), lymph node metastasis(N stage), TNM stage, tumor differentiation(grade) and survival was statistically analyzed by chi-square test. According to the follow-up data, Kaplan-Meier method and Log-rank test were employed to explore the correlation between REG Iα expression and survival. The Cox regression analysis was performed to evaluate the connection between expression of REG Iα and prognosis. Further, Kaplan-Meier method and Log-rank test were explored the connection between REG Iα expression and adjuvant chemotherapy.RESULTS 135 cases were included in this study with 82 cases receiving surgery only and 53 cases receiving both surgery and adjuvant chemotherapy. REG Iα protein expression was localized in the cytoplasm of cells, and 43.70%(59/135) cases menifested with REG Iα positive. There was no significant association between expression of REG Iα and clinical pathological features.In all ESCC patients, the REG Iα-positive patients had a worse 3-year overall survival than REG Iα-negative patients(χ2=6.811, P=0.009). In the surgery group(n=82), the 3-year overall survival rate of REG Iα-positive patients was significantly worse than REG Iα-negative patients(25.00% vs. 52.08%, χ2=9.725, P=0.002). However, there was no significant difference in the 3-year overall survival rate between REG Iα-positive and REG Iα-negative patients in the adjuvant group(n=53)(57.69% vs. 52.08%, χ2=0.696, P=0.404). In all ESCC patients, adjuvant chemotherapy improved the 3-year overall survival rate compared with surgery alone(58.49 vs. 42.68,χ2=2.822,P=0.093), but there was no significant difference. Stratified analysis revealed that there was significantly difference in REG Iα-positive patients(55.55% vs. 53.06%, χ2=0.394, P=0.530), patients with lymph node metastasis(51.43% vs. 28.13%,χ2=5.421,P=0.020), and patients with smoking-index≥400(60.71% vs. 28.57%,χ2=4.737,P=0.030) who received adjuvant chemotherapy compared with surgery alone.CONCLUSIONS REG Iα-positive expression is possible a predictor of worse survival in ESCC patients, but REG Iα-positive expression patients are more likely to get benefit from adjuvant chemotherapy, which means that REG Iα-positive expression ispossible a chemosensitive marker in ESCC patients.