| 摘要: | 研究目的
食道鱗狀上皮細胞癌為預後最不佳的癌症之一，在台灣它是癌症死因第八位。要改善食道癌之治療效果必須更了解此疾病之致病機轉。A Disintegrin And Metalloproteinase (ADAMs)是一種第一型的過膜蛋白質(transmembrane protein)，許多研究顯示不同的ADAMs在不同的腫瘤有過度表現，且有些與預後相關。過量表現ADAM-9在腎臟、肺、攝護腺癌被報導。然而，ADAM-9和食道鱗狀上皮細胞癌之間的關係仍然未知。本研究的目的是要藉由免疫組織化學染色探討ADAM-9在食道鱗狀上皮細胞癌病人的表現和其與預後因子之關係。
研究方法
八十八位自2000年至2009年在中國醫藥大學附設醫院接受食道切除之食道鱗狀上皮細胞癌患者被選入此研究。ADAM-9之表現量用免疫組織化學染色測量，藉由比較ADAM-9表現多和少與臨床病理因子之間的關係來評估ADAM-9表現與預後之關係。
研究結果
藉由免疫組織化學染色我們發現在食道鱗狀上皮細胞組織中有不同的ADAM-9表現量，其表現強度為：44 (50%)無表現；16 (18.1%)弱；14 (15.9%)中度；11 (12.5%)強；3 (3.5%)極強。我們發現ADAM-9只在食道鱗狀上皮細胞癌組織表現不同強度，在癌細胞旁的正常組織並不表現。
經由比較ADAM-9表現量與食道鱗狀上皮細胞癌臨床病理因子我們發現ADAM-9的表現量與腫瘤大小、淋巴數目、腫瘤分化、腫瘤位置無關。不過ADAM-9的表現量與轉移狀態 (metastasis status)有相關 (chi-square tests, P=0.02)。ADAM-9的表現量和病人存活時間 (Kaplan-Meier)並無統計顯著差異。
研究結論
這是第一篇研究探討ADAM-9表現與食道鱗狀上皮細胞癌。和許多癌症相似我們發現有些食道鱗狀上皮細胞癌患者有ADAM-9過量表現，根據我們的研究ADAM-9過量表現與食道鱗狀上皮細胞癌患遠端轉移相關，我們需要共多研究來了解ADAM-9食道鱗狀上皮細胞癌扮演的角色。
Introduction
Esophageal squamous cell carcinoma (ESCC) is one of the malignancies which exhibited poor prognosis. It ranked 8th cancer-related death in Taiwan. To improve the outcome, it is necessary and important to understand the molecular mechanism of this cancer. A Disintegrin And Metalloproteinase (ADAMs) are type I transmembrane protein. Many reports have documented that several ADAMs differently express in various tumor entities and partial convey prognostic information. The over-expression of ADAM-9 was found in the patients with lung, kidney, prostate cancer. However, the relationship between expression of ADAM-9 in ESCC patient was not clear. The aims of the present study is to examine the expression of ADAM-9 in ESCC patients and to investigate its prognostic relevance by immunohistochemical analyse.
Methods
88 patients with ESCC received esophagectomy between 2000 and 2009 were enrolled. The expression profile of ADAM-9 in association with the clinicopathological factors was determined by immunohistochemical stain. The prognostic value was investigated by comparing the clinicopathological features and ADAM-9 staining intensities.
Results
The results showed ADAM-9 staining intensity was: 44 (50%) negative, 16 (18.1%) weak, 14 (15.9%) moderate, 11 (12.5%) strong and 3 (3.5%) very strong. ADAM-9 was not detected in tumor adjacent normal esophageal tissue. The ADAM-9 protein expression was not significantly associated with age, pT status, pN status, tumor grade, smoking, betel nut chewing, drinking, tumor location and pathological stages. However, it was significantly associated with pM status (P=0.02). Using univariate analysis (Kaplan-Meier) of patient survival, higher expression of ADAM-9 in ESCC was not significantly associated with shorten survival times.
Conclusion
To our knowledge, this is the first report exam ADAM-9 in ESCC patients. Expression of ADAM-9 in ESCC tissue is consistent with other cancer entities. Based on our results, ADAM-9 protein expression might serve as predictive marker for ESCC metastasis. Further studies are needed to explore the pathophysiological function of ADAM-9 in the advanced esophageal cancer. |
