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Objective To explore the the prognostic significance of MMP-9,uPA and uPAR protein expression and its relationship with clinical-pathologic factors in esophageal squamous cell carcinoma treated by radiotherapy.Methods MMP-9,uPA and uPAR protein expression was measured in 59 esophageal car cinomas and 41 peri-carcinoma tissues with immunohistochemistry.The relationship between the protein expression and the clinical-pathological parameters was analyzed,and the prognostic factors in esophageal squamous cell carcinoma treated by radiotherapy alone was evaluated.Results The rates of positive expression of MMP-9.uPA and uPAR were 85%,76%and 78%in esophageal carcinoma and 39%,49%and 44%in peri-carcinoma tissues(x2=22.54,8.04 and 12.18;P=0.000,0.005 and 0.000).The rates of positive expression of MMP-9 was 79%and 100%when the depth of tumor invasion was≤2 am and＞2 cm(P=0.048),respectively.The expression of uPA was significantly correlated with the status of fat interspace between the esophageal lesion and the vertebra in CT seaning image.When the fat interspace existed and disappeared,the rates of strong positive expression was 44%and 70%,respectively(χ2=4.21,P=0.040).The positive expression rate of uPA was significantly correlated with distant metastasis.which was 100%in patients with distant metastasis and 68.89%in those without distant metastasis(χ2=4.12,P=0.042).r11}lepositive expression rate of MMP-9.uPA and uPAR did not affect the prognosis and the short-term result of esoph.ageal carcinoma treated by radiotherapy alone.Conclusions The protein expression of MMP-9,uPA and uPAR may correlate with local infiltration and distant metastasis in esophageal squamous cell carcinoma.Protein expression may not influence the prognosis of esophageal carcinoma treated by radio therapy,though long time followed-up is stil needed.
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Objective To investigation the pathological characteristics of esophageal squamous cell carcinoma to provide reference criteria for delineating the target area in radiotherapy.Methods Fifty-two patients from the Fourth Hospital of HeBei Medical University underwent resection whom all had been proved to have esophageal squamous cell carcinoma before operation.Chest CT was scanned and transmitted to the 3- dimensional conformal planning system for radiotherapy by VRX-16 scanner.The lesion of esophageal carcinoma was delineated in the 3-dimensional rebuild CT image and the lesion volume was computed by digital rebuild program.Every surgically resected specimen was made into pathologic giant section.The actual size of the specimen was obtained by calculating the size under the microscope with the shrinkage ratio.Multicentric carcinomatous lesion,severe dysplasia and direct intramural infiltration were observed in the giant section with a microscope and the order of such pathological characteristics were analysed statistically.Results 1.The tumor length by different method of preparation of operated specimens differed obviously.The longest was shown by CT. 2.Multicentric carcinomatous lesion was found in 15(29%)cases out of 52 patients.Proximal to the tumor,the mean distance between the multicentric carcinomatous lesion and the main lesion plus the length of the multicentric carcinomatous lesion was 3.02?1.45cm.Distal to the tumor,it was 2.60?2.44 cm.Severe dysplasia was found in 28 patients.Proximally,the mean distance between the severe dysplasia and the main lesion plus the length of the severe dysplasia was 2.45?1.30 cm.Distal to the tumor,it was 3.24?2.19 cm.Direct intramural infiltration was found in 41 patients,of which the mean length being 2.80?1.52 cm proximally and 2.02?1.51 cm distally. 3.Tumor thrombus was found in 6 patients and lymphoduct infiltration in 36 patients.Direct intramural infiltration was found at higher incidence in specimens complicated with lymphoduct infiltration(86%)and those complicated with tumor thrombus(91%).There were no apparent factors affecting severe dysplasia.The proximal distance to direct intra- mural infiltration was much longer than distally.Conclusions Multicentric carcinomatous lesion,severe dysplasia and direct intramural infiltration may be observed in esophageal squamous cell carcinoma.Multicentric carcinomatous lesion and direct intramural infiltration are obviously correlated with lymphoduct infiltration.To cover 95% of the microscopic extension,a margin of 5.0 cm is needed proximal to the base of gross tumor volume,and 7.5 cm distal to it.To cover 90% of the microscopic extension,a margin of 4.5 cm is needed proximally,and 5.0 cm distally.