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目的：探讨内窥镜活检标本PCNA、CyclinD1蛋白表达和DNA含量分型同时检测对食管癌放疗预后的指导作用。方法：1979年11月至1996年12月，104例食管癌患者在我院接受术前放疗及根治性食管癌切除术，其中男64例，女40例；平均年龄51岁（31～72岁）。均用前后两野垂直照射，肿瘤剂量30～40Gy／15～20次，3～4周。结果：PCNA蛋白高表达率55．8％，CyclinD1蛋白表达阳性率为62．5％，DNA含量Ⅰ、Ⅱ型占21．3％，Ⅲ、Ⅳ型占78．7％。PCNA蛋白高表达较低表达者预后好，P＝0．02，并与肿瘤大小、淋巴结转移状态和放疗后病理改变均有明显相关性；CyclinD1蛋白表达和DNA含量对预后均无显著性影响且与临床病理参数无明显相关性；但CyclinD1蛋白和DNA含量之间有显著性相关，P＝0．03，两者结合对食管癌预后有显著性影响，P＝0．01；Cox模型分析显示，仅淋巴结转移状态、术前放疗剂量和放疗前PCNA蛋白表达对预后有比较明显的影响。结论：活检标本PCNA蛋白表达有可能预示食管癌预后，CyclinD1蛋白和DNA含量结合有可能成为新的评价指标。
Objective: To investigate the role of simultaneous detection of PCNA, CyclinD1 protein expression and DNA content in endoscopic biopsy specimens for prognosis of esophageal cancer. Methods: Between November 1979 and December 1996, 104 patients with esophageal cancer underwent preoperative radiotherapy and radical esophageal resection in our hospital, including 64 males and 40 females with an average age of 51 years (ranging from 31 to 72 years ). Before and after use both wild vertical irradiation, tumor dose 30 ~ 40Gy / 15 ~ 20 times, 3 ~ 4 weeks. Results: The positive rate of PCNA protein was 55.8% and the positive rate of CyclinD1 protein was 62.5%. The content of DNA in type Ⅰ and type Ⅱ was 21.3% and that in type Ⅲ and Ⅳ was 78.7%. The prognosis of patients with high expression of PCNA was significantly lower than that of patients with low expression of PCNA (P = 0.02), and significantly correlated with tumor size, lymph node metastasis and pathological changes after radiotherapy. The expression of CyclinD1 protein and DNA content had no significant effect on prognosis There was no significant correlation between the expression of CyclinD1 protein and DNA content (P = 0.03). The combination of them both had a significant effect on the prognosis of esophageal cancer (P = 0.01). Cox model analysis showed , Lymph node metastasis only, preoperative radiotherapy dose and PCNA protein expression before radiotherapy have a more significant impact on prognosis. Conclusion: The biopsy specimens PCNA protein expression may predict the prognosis of esophageal cancer, CyclinD1 protein and DNA content may be a new evaluation index.