【摘要】 目的 探討喉癌組織中 EGFL7基因 mRNA表達與喉癌分化、轉移及臨床預后的關系。 方法 收集2008年5—11月共42例行喉癌手術患者的切除標本。用免疫組織化學法檢測EGFL7蛋白在42例喉癌組織和配對癌旁組織中的表達情況，提取腫瘤及癌旁組織配對標本的總 RNA，用逆轉錄（RT）-PCR方法測定EGFL7基因表達，蛋白質印跡法測定EGFL7蛋白的表達，并結合臨床資料，對 EGFL7基因差異表達與喉癌患者臨床表現的相關性進行分析研究。 結果 對42例配對標本分別進行 EGFL7 mRNA熒光檢測比較，30例標本的腫瘤組織中EGFL7基因mRNA表達明顯高于癌旁正常喉組織。22例標本的腫瘤組織中EGFL7蛋白表達明顯高于癌旁正常喉組織。EGFL7 mRNA的表達與喉癌淋巴結轉移和浸潤深度密切相關（Plt;0.05），而與患者的性別、年齡、吸煙、腫瘤分化程度等無關（Pgt;0.05）。 結論 EGFL7基因在喉癌組織中表達狀態與喉癌的生長和浸潤轉移關系密切，EGFL7基因可望作為喉癌病情發展及指導臨床治療的標記物之一。【Abstract】 Objective To investigate the association of EGF-like-domain, multiple 7 (EGFL7) mRNA expression level with the differentiation, metastasis and prognosis of laryngocarcinoma. Methods Tissue specimens were obtained from 42 patients undergoing surgery for laryngocarcinoma between May and November, 2008. Immunohistochemistry was used to detect the level of EGFL7 in the 42 tumor tissues and matched adjacent normal tissues. Reverse transcriptional PCR (RT-PCR) was performed for amplification of EGFL7 mRNA from the 42 tumor tissues and matched adjacent normal tissues, and westerblot was adopted to determine EGFL7 protein expression. The differential EGFL7 mRNA expression was analyzed for its association with the clinical manifestations of the patients. Results EGFL7 mRNA expression was detected in all the laryngocarcinoma tissues and normal tissues adjacent to the carcinoma using fluorescence method. EGFL7 mRNA expression was significantly higher in the tumor tissues than in the adjacent tissues in 30 cases, and EGFL7 protein expression was also significantly higher in the tumor tissues than in the adjacent normal laryngeal tissues in 22 cases. Expression of EGFL7 mRNA was highly correlated with lymph node metastasis and T classification (Plt;0.05), but was not correlated with the patients’ gender, age, or tumor differentiation (Pgt;0.05). Conclusions EGFL7 mRNA expression is correlated closely with the differentiation and metastasis of laryngocarcinoma. EGFL7 may serve as a marker for assessing the progression of laryngocarcinoma and provide assistance for clinical therapeutic decisions.
Objective To investigate the prognostic value of preoperative inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and fibrinogen-to-prealbumin ratio (FPR), for postoperative survival in patients with resectable esophageal squamous cell carcinoma (ESCC). Additionally, to construct and validate a prognostic model for ESCC based on these inflammatory markers combined with TNM staging. Methods We retrospectively analyzed the clinical data of patients with histologically confirmed ESCC who underwent surgical resection at the First Affiliated Hospital of the University of Science and Technology of China during 2017. Receiver operating characteristic (ROC) curves were used to determine the optimal cut-off values for preoperative NLR, PLR, SII, and FPR. Clinicopathological characteristics were compared between patient groups with different levels of these markers. Survival analysis was performed using the Kaplan-Meier method, and univariate and multivariate regression analyses were conducted using the Cox proportional hazards model to identify prognostic factors. Nomograms for predicting overall survival (OS) and disease-free survival (DFS) were constructed using R software. The model's discrimination was assessed with ROC curves, its calibration was evaluated with calibration curves, and its clinical utility was determined by decision curve analysis (DCA). Results A total of 224 patients who underwent surgery for ESCC were included, comprising 180 males and 44 females. The optimal preoperative cut-off values of NLR, PLR, SII, and FPR for predicting postoperative OS were 2.70, 140.34, 360.73, and 0.015, respectively. The 5-year OS and DFS rates in the high-NLR group were lower than in the low-NLR group (both P<0.001). Similarly, patients in the high-PLR group (P=0.005 and P=0.009, respectively), high-SII group (P=0.008 and P=0.018, respectively), and high-FPR group (both P<0.001) had lower 5-year OS and DFS rates compared to their low-level counterparts. Multivariate Cox regression analysis revealed that patient age, T stage, N stage, tumor differentiation, and NLR>2.70 et al were independent prognostic factors for both OS and DFS. Based on these factors, nomograms for OS and DFS were constructed. The area under the ROC curve (AUC) for 3- and 5-year OS were 0.966 and 0.907, respectively, and for 3- and 5-year DFS were 0.960 and 0.919, respectively. The calibration curves showed good agreement between predicted and actual outcomes. DCA demonstrated that the models provided a positive net benefit for all patients under intervention. Conclusion Preoperative levels of NLR, PLR, SII, and FPR are associated with the prognosis of patients with ESCC, with NLR being an independent prognostic predictor. The nomogram models, constructed based on patient age, tumor differentiation, T stage, N stage, and preoperative NLR level, can accurately predict the prognosis of patients with ESCC. These models may help guide preoperative clinical decision-making and tailor treatment and follow-up strategies.