Molecular Targets And Their Clinical Significance For Esophageal Squamous Cell Carcinoma

Objective: To analyze the efficacy between postoperative prophylactic radiotherapy and salvageradiotherapy after radical resection for stageⅠB-ⅢC esophageal squamous cell carcinoma（ESCC), and to explore the prognostics factors.Methods: Clinical and pathological data of patients who conformed to the screening criteria fromAugust2008to October2011were analyzed retrospectively.The median Disease-free survival（DFS）and overall survival (OS) were analyzed using the Kaplan-Meier method, univariate andmultivariate analyses were measured using the log-rank test and cox regression model,respectively.Results: Finally,59patients were enrolled in the analysis. In median follow-up time of32months,the median DFS and OS were22.5months and30.7months, respectively. The median DFS inpostoperative prophylactic radiotherapy group was obvious higher than that in salvageradiotherapy group (28.4months vs.19.8months, p=0.032), but no significant difference inmedian OS was observed（35.7months vs.26.2months, p=0.115). Univariate analysis showedthat Karnofsky performance scores(KPS) before radiotherapy, pathological stage, pathological Tstage, N stage and interval time from resection to radiation were favorably associated with OS(p <0.050). Multivariate analysis revealed that pathological stage was an independent prognosticfactors for OS(p <0.001). For patients who with recurrence tumor after radiotherapy, the medianOS in retreatment group was improved3.5months compared to best support care, and thedifference was significant（7.7months vs.4.2months，p=0.024).Conclusion: Postoperative prophylactic radiotherapy could prolong DFS for patients withradically resected stageⅠB-ⅢC ESCC, but could not improve the OS. KPS before radiotherapy,pathological stage, pathological T stage, N stage and interval time from resection to radiation were favorably associated with OS, but only pathological stage was an independent prognostic factor. Objective: To investigate the expression of FADD and NKX3-1mRNA in patients with radicallyresected stageⅠB-ⅢC esophageal squamous cell carcinoma(ESCC), and analyze their correlationwith clinical pathological characteristic and prognosis of ESCC.Methods: The expression of FADD and NKX3-1mRNA in59patients with radically resectedESCC specimens were detected by quantitative Real-Time PCR (qRT-PCR). The independentt-test was used to compare the differences between groups,the correlations of FADD and NKX3-1mRNA expression with tumor invasive depth and lymph node metastasis were analyzed using χ2test, univariate and multivariate analyses were measured using the log-rank test and cox regressionmodel, respectively.Results: The positive rate of FADD and NKX3-1mRNA expression in59ESCC tissue were27.1%and25.4%,and the relative expression intensity were1.29±0.26and2.02±0.43,respectively. The result of independent t-test showed that the expression intensity of FADD andNKX3-1mRNA had no significant difference in stageⅠB-ⅢC ESCC. No significant correlationswere observed between FADD and NKX3-1mRNA expression level and tumor invasive depth orlymph node metastasis (p>0.050). Survival analysis showed that the median DFS（15.0monthsvs.27.4months, p=0.008）and OS（17.6months vs.35.7months, p <0.001）were significantlyreduced in FADD positive group compared to control. While the median DFS（19.8monthsvs.24.5months, p=0.358）and OS（26.2months vs.31.4months, p=0.341）had no obviousreduced in NKX3-1positive expression group. Multivariate analysis revealed that the expressionof FADD was associated with OS (p=0.002).Conclusion:(1) The positive expression of FADD in ESCC may has a poor prognosis, but it wasnot associated with depth of invasion or lymph node metastasis;(2) NKX3-1expression in ESCCmay was not associated with depth of invasion,lymph node metastasis or their prognosis.