بررسي گيرنده هاي استروژن و پروژسترون در كارسينوم سلول سنگفرشي مري و ارتباط آن با بقاء بيماران

Evaluation of Estrogen and Progesterone Receptors in Esophageal Squamous Cell Carcinoma and their Relationship with Survival

ﺯﻣﻴﻨﻪ ﻭ ﻫﺪﻑ: ﻣﻴﺰﺍﻥ ﻭﻗﻮﻉ ﺳﺮﻃﺎﻥ ﻣﺮﻱ ﺩﺭ ﻣﺮﺩﺍﻥ ﻧﺴﺒﺖ ﺑﻪ ﺯﻧﺎﻥ 3 ﺑﺮﺍﺑﺮ ﺑﻴﺸﺘـﺮ ﺑﻮﺩﻩ ﻭ ﭘﻴﺶ ﺁﮔﻬﻲ ﺁﻥ ﺩﺭ ﺯﻧﺎﻥ ﺑﻬﺘﺮ ﺍﺯ ﻣﺮﺩﺍﻥ ﻣﻲ ﺑﺎﺷﺪ. ﻋﻼﻭﻩ ﺑﺮ ﺁﻥ ﺗﺤﻘﻴﻘﺎﺗﻲ ﺩﺭ ﺭﺍﺑﻄﻪ ﺑﺎ ﺍﺭﺗﺒﺎﻁ ﺭﺳﭙﺘﻮﺭﻫﺎﻱ ﻫﻮﺭﻣـﻮﻥ ﻫﺎﻱ ﺟﻨﺴﻲ ﻭ ﺭﺷﺪ ﺗﻮﻣـﻮﺭ ﺳﺮﻃﺎﻥ ﻣﺮﻱ ﺩﺭ ﺣﻴﻮﺍﻧﺎﺕ ﺁﺯﻣﺎﻳﺸﮕﺎﻫﻲ ﺻﻮﺭﺕ ﮔﺮﻓﺘﻪ ﺍﺳﺖ ﻛﻪ ﺍﻣﻜﺎﻥ ﺍﺭﺗﺒﺎﻁ ﺳﺮﻃﺎﻥ ﻣﺮﻱ ﺭﺍ ﺑﺎ ﻫـﻮﺭﻣﻮﻥ ﻫﺎﻱ ﺟﻨﺴﻲ ﺗﻘـﻮﻳﺖ ﻛﺮﺩﻩ ﺍﻧﺪ. ﺍﻳﻦ ﭘﮋﻭﻫﺶ ﺑﺎ ﻫﺪﻑ ﺑﺮﺭﺳﻲ ﻭﺟﻮﺩ ﮔﻴﺮﻧﺪﻩ ﻫﺎﻱ ﺍﺳﺘﺮﻭﮊﻥ ﻭ ﭘﺮﻭﮊﺳﺘﺮﻭﻥ ﺩﺭ ﻛﺎﺭﺳﻴﻨﻮﻡ ﺳﻠﻮﻝ ﺳﻨﮕﻔـﺮﺷﻲ ﻣـﺮﻱ ﻭ ﺍﺭﺗﺒﺎﻁ ﺁﻥ ﺑﺎ ﺑﻘﺎﺀ ﺑﻴﻤﺎﺭﺍﻥ، ﺍﻧﺠﺎﻡ ﺷﺪﻩ ﺍﺳﺖ. ﻣﻮﺍﺩ ﻭ ﺭﻭﺵ ﻫﺎ: ﺩﺭ ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ 100 ﺑﻴﻤﺎﺭ ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎﻥ ﺳﻠﻮﻝ ﺳﻨﮕﻔـﺮﺷﻲ ﻣـﺮﻱ )SCC( ﺑﺪﻭﻥ ﻣﺘﺎﺳﺘـﺎﺯ ﻛﻪ ﺩﺭ ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ﻫﺎﻱ ﺷﻬﺪﺍﺀ ﺗﺠﺮﻳﺶ، ﺍﻣﺎﻡ ﺧﻤﻴﻨﻲ، ﻃﺎﻟﻘﺎﻧﻲ ﻭ ﺑﻘﻴﻪ ﺍ... ﺍﻻﻋﻈﻢ ﻋﺞ( ﺗﺤﺖ ﻋﻤﻞ ﺟﺮﺍﺣﻲ ﺍﺯﻭﻓﺎﮊﻛﺘـﻮﻣﻲ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻪ ﺑﻮﺩﻧﺪ، ﻣـﻮﺭﺩ ﺑﺮﺭﺳﻲ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻨﺪ. ﺷﻨﺎﺳﺎﻳﻲ ﺭﺳﭙﺘـﻮﺭﻫﺎ ﺑﻪ ﺭﻭﺵ )LSAB( Labelled Strep Avidin Biotin ﺍﻧﺠﺎﻡ ﺷﺪ ﻭ ﺍﺭﺗﺒـﺎﻁ ﺑﻴﻦ ﻭﺟـﻮﺩ ﺭﺳﭙﺘﻮﺭﻫﺎﻱ ﺍﺳﺘـﺮﻭﮊﻧﻲ ﻭ ﭘﺮﻭﮊﺳﺘـﺮﻭﻧﻲ ﺑﺎ ﺟﻨﺲ، ﻣﺮﺣﻠﺔ ﭘﻴﺸﺮﻓﺘﮕﻲ ﺗﻮﻣﻮﺭ )stage(، ﻣﺤﻞ ﺗﻮﻣـﻮﺭ ﻭ ﺑﻘـﺎﺀ ﺑﻴﻤﺎﺭ ﻣﻮﺭﺩ ﺑﺮﺭﺳﻲ ﻗﺮﺍﺭ ﮔﺮﻓﺖ. ﺗﺴﺖ ﻫﺎﻱ ﺁﻣﺎﺭﻱ Fisher’s exact test, t-Test, chi-square ﺑﺮﺍﻱ ﺗﺠﺰﻳﻪ ﻭ ﺗﺤﻠﻴـﻞ ﺍﻃﻼﻋﺎﺕ ﺑﻪ ﮐﺎﺭ ﮔـﺮﻓﺘﻪ ﺷﺪ ﻭ ﺑﺮﺍﻱ ﺗﻌﻴﻴﻦ ﻃﻮﻝ ﻋﻤـﺮ ﺍﺯ ﺭﻭﺵ ﻛﺎﭘﻼﻥ ﻣﺎﻳﺮ ﻭ Log Rank testﺍﺳﺘﻔﺎﺩﻩ ﮔـﺮﺩﻳﺪ. ﻣﻘﺎﺩﻳﺮ 0/05

Introduction & Objective: The incidence of esophageal cancer is 3 times higher in men than in women and its prognosis is better for women than men. Furthermore, experimental animal models investigations about sex hormone receptors and tumoral growth, supports possible implication of sex hormones in esophageal cancers. This study aimed to evaluate estrogen and progesterone receptors in esophageal squamous cell carcinoma and their relation with patients’ survival. Materials & Methods: In this study 100 cases of non-metastatic esophageal carcinoma (50 males & 50 females), which underwent radical esophagectomy in Shohadaye Tajrish, Taleghani, Imam Khomeini and Baghiyatallah hospitals, included. Receptors identified by Labeled Strep Avidin Biotin (LSAB) method and relationship between presence of receptors and sex, tumor stage, tumor location and patients survival evaluated. Data analysis performed using chi-square, t-test, Fisher’s exact test and survival analyzed with Kaplan-Meier and log rank tests. P-values <0.05 considered statistically significant. Results: Estrogen receptors (ERs) found in none of cases and progestron receptors (PRs) were positive in 14% of cases. In PR positive cases proportion of females was 25% higher comparing to PR negative cases (P=0.08). Age of PR positive patients ranged from 40-79 years with average of 54.7±12.1 years and age of PR negative patients ranged from 32-85 with average of 59.4±11.8 years (P=0.1). There were no significant difference in sex, tumor location, lymph node involvement, depth of invasion, and tumor grade between PR positive and PR negative cases (P>0.05). Average survival time of PR positive cases was 15.8 months and in PR negatives was 10.3 months (P=0.68). Conclusions: There was no estrogen positive case in this study and progesterone receptors were positive in few cases. There were no statistically significant relation between prognosis of patients and tumor specifications and presence of progesterone receptors in this study but further larger studies are suggested in this regard.