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[目的]探讨表皮生长因子受体(EGFR)基因突变和表达在食管鳞状细胞癌中的意义。[方法]分别应用real-time RT-PCR、免疫组化技术检测105例食管鳞状细胞癌组织中EGFR m RNA及蛋白表达水平,应用ADx-ARMS和PCR-Sanger测序法检测上述标本中EGFR基因18、19、20、21外显子突变,分析EGFR表达状态与临床、病理特征及患者生存期的关系。[结果]105例食管鳞状细胞癌组织中仅3例(2.9%,3/105)呈EGFR蛋白弱阳性表达,与癌旁组织相比无显著性差异(P>0.05)。92.4%(97/105)的食管鳞状细胞癌组织中EGFR m RNA表达水平上调,与癌旁组织相比有显著性差异(P=0.000)。且肿瘤组织EGFR m RNA表达水平分别与淋巴结转移(P=0.001)、神经浸润(P=0.039)及TNM分期(P=0.003)显著相关。Kaplan-Meier生存分析显示,EGFR m RNA表达水平上调患者的平均生存期(16.7个月)显著短于EGFR m RNA表达正常/下调患者(19.1个月),其中8个EGFR m RNA正常表达病例生存情况均良好。多因素Cox回归分析表明,EGFR m RNA为食管鳞状细胞癌患者独立的预后因子,其相对危险度为1.368(P<0.001)。[结论]EGFR m RNA可作为食管鳞状细胞癌患者预后标志物,其表达上调提示患者预后不良。
[Objective] To investigate the significance of epidermal growth factor receptor (EGFR) gene mutation and expression in esophageal squamous cell carcinoma. [Methods] The expression of EGFR m RNA and protein in 105 esophageal squamous cell carcinoma tissues were detected by real-time RT-PCR and immunohistochemistry respectively. The expression of EGFR mRNA and protein was detected by AD-ARMS and PCR-Sanger sequencing 18,19,20,21 exon mutations, analysis of EGFR expression status and clinical, pathological features and the relationship between the survival of patients. [Results] Only 3 cases (2.9%, 3/105) of esophageal squamous cell carcinoma showed a weak positive expression of EGFR protein, which showed no significant difference compared with the adjacent non-cancerous tissues (P> 0.05). The expression of EGFR m RNA in 92.4% (97/105) esophageal squamous cell carcinoma tissues was up-regulated, which was significantly different from the adjacent tissues (P = 0.000). The expression of EGFR m RNA in tumor tissues was significantly correlated with lymph node metastasis (P = 0.001), neural invasion (P = 0.039) and TNM stage (P = 0.003), respectively. Kaplan-Meier survival analysis showed that the average survival of patients with EGFR m RNA expression was significantly shorter (16.7 months) than that of patients with normal / down-regulated EGFR m RNA expression (19.1 months), of which 8 cases were normal EGFR m RNA expression The situation is good. Multivariate Cox regression analysis showed that EGFR m RNA was an independent predictor of esophageal squamous cell carcinoma with a relative risk of 1.368 (P <0.001). [Conclusion] The EGFR m RNA can be used as a prognostic marker in patients with esophageal squamous cell carcinoma, whose up-regulation of EGFR m RNA indicates that the prognosis is poor.