| Objectives: esophageal carcinoma has a high morbidity in our country. The patient with this disease has a low five years survival rate and the metastasis is very quickly. This disease is harmful to the health of people. In recent years, the surgery technique, chemotherapy and radiotherapy have a quickly development, but the survival rate hasn't risen parallelly. The reason of this phenomenon is micro-metastasis through the lymph or blood vessels before the surgery.CD44 transmembrane glycoprotein is a cell adhesion molecule involved in cell-cell and cell-matrix interactions. It originally was described as a lymphocyte homing receptor on circulating lymphocytes, cell adhesion, activation of leukocytes, and migration of cells. At least 20 variants(v)of CD44 have been reported due to the alternative splicing of 10 exons(v1-v10)that encode the membrane's proximal portion of the extracellular domain. Günthert is the first to show that the expression variants of CD44 endowed a non-metastasis line of cells with metastatic potential in a rat carcinoma model. Soon after, thisvariant was affirmed to be CD44v6. It since has been reported that the expression of variant 6 of CD44 is correlated with invasion by and metastasis of certain types of human carcinoma. There appears to be a correlation between the expression of CD44v6 and tumor progression, metastasis, and prognosis in colorectal carcinoma, breast carcinoma and certain types of gastric carcinoma. Soluble CD44 splice variants containing exon v6 (sCD44v6) have been founded in the serum of tumor patients. Serum concentrations of sCD44v6 have been found to be elevated significantly in tumor patients. Hitherto, there are few researches on CD44v6 in esophageal carcinoma with immunohistochemistry or RT-PCR methods which kill the time and need great efforts, and they had different options of expression of CD44v6 in esophageal carcinoma. To our knowledge, a possible correlation between the serum and urine concentration of sCD44v6 and histomorphologic variables have not been examined in patients with esophageal squamous cell carcinoma. The purpose of this study was to evaluate the serum and urine levels of soluble CD44 splice variants containing exon v6 (sCD44v6) in patients with esophageal squamous cell carcinoma and to elucidate their significance of pre-operation and post-operation sCD44v6 levels. Moreover, we investigate the correlation between the expression of CD44v6 gene proteins and their clinicalsignificance in esophageal carcinoma tissue. By these studies, we enucleate the relationship between expression of CD44v6 and biological behaviors in human esophageal squamous cell carcinoma. These studies will be helpful to us for the diagnosis and treatment in esophageal squamous cell carcinoma.Method: We determined the serum and urine levels of sCD44v6 using an enzyme—linked immunoabsorbent assay(ELISA)in patients with esophageal squamous cell carcinoma .Moreover, we evaluated the expression of CD44v6 protein in the tumor cells of both primary esophageal squamous cell carcinoma and metastatic lymph nodes by flow cytometry (FCM) and immunofluorescence technique. Serum and urine samples were obtained from 48 primary esophageal carcinoma patients before surgery. In the patients, we have acquired the serum and urine of 43 cases on the 14th postoperative day. To study the local expression of CD44v6 in human esophageal carcinoma, we selected 53 cases esophageal squamous cell carcinoma tissue and 18 metastatic lymph nodes which were Formalin-fixed. Results: (1) In health controls, the levels of serum and urine sCD44v6 are 182.9±14.61ng/ml and 41.32±4.09ng/ml ,whereas the serum and urine sCD44v6 levels (±s, ng/ml) before surgery in esophageal squamous cell carcinoma patients were 252.83±33.93 ng/ml and 49.45±9.67ng/ml ,which were significantly higher than those of healthy subjects(P<0.01). (2) In esophageal squamous cell carcinoma, the serum and urine levels of sCD44v6 patients after surgery were sign... |
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