The Correlation Between The Recurrence Pattern And Tiam1 Level After The Radical Surgery Of Esophageal Carcinoma

Objective To investigate the relapse pattern after radical surgery for left thoracic esophageal carcinoma,the radiotherapy field design with three dimensional treatments after the radical surgery and the relationship between the levels of Tiaml protein,the prognosis and the relapse part.MethodsA total of 96 diagnosed esophageal cancer patients with postoperative relapse were enrolled,and they all underwent radical surgery for thoracic esophageal carcinoma and RO resection.Patients with postoperative radiotherapy were divided into:Recurrence of above the tracheal carina,Lymph node metastasis and anastomotic recurrence were all named as relapse progress of the part above tracheal carina;Recurrence lower part of tracheal carina and abdominal lymph node metastasis,which including the cardia,left gastric artery and the abdominal aorta(above the renal artery)was development of the part under tracheal carina.When the place of relapse was not in the radiotherapy target,it was defined as distant organ metastasis.Two or three types of progresses in the three categories was referred to as the progress of the compound.The relapse progress was retrospectively analyzed.More cases were involved in the survey.The categories of relapse included local metastasis,distant metastasis,and mixed metastasis.Postoperative stage was performed according to the AJCC/UICC-2010 standard.The original place was divided into upper thoracic,middle thoracic and lower thoracic segments in the light of AJCC/UICC-2010 standard.The process of relapse was divided into local metastasis,distant metastasis,and mixed metastasis.Finally,All 295 cases in the 306 patients were involved into statistic analyze.The expression of Tiaml was detected by immunohistochemical imaging to analyze the relationship between the level of Tiaml,disease-free survival(DFS)and the relapse place.ResultsAmong the 96 patients,the cases with progress above the carina,progress under the carina,distant metastasis,and complex progress respectively accounted for 53.1%,13.5%,22.9%and 10.4%,and the number of progress above the carina was the most.Stratified analysis was made on cases received radiotherapy or chemoradiotherapy,and there were 37.1%of the patients with progress above the carina.While there were 63.8%of the patients,who received no chemoradiotherapy,with progress above the carina.A total of 236 cases in 295 patients recurs,and among them there were 145 patients with high level of Tiaml,150 patients with middle level of Tiaml and low level of Tiaml.The expression of Tiaml was correlated with the pathological stage,lymph node metastasis and T stage.The level of Tiaml was correlated with the time of DFS,and patients with high expression of Tiaml had the poor prognosis.Patients with late pathological stage,high T stage and high expression of Tiaml suggested that it is prone to distant metastasis.ConclusionThe local recurrence was the main metastasis of esophageal carcinoma.For the patients needing postoperative radiotherapy,prophylactic irradiation therapy in upper mediastinum and supraclavicular region could provide the benefit to the control of local recurrence;Moreover,Lymphatic drainage was needed to be included.The patients with high expression of Tiaml in the pathological tissues undergoing the radical surgery of esophageal carcinoma had a poor prognosis.Additionally,postoperative distance metastasis was correlated with the level of Tiaml.