Abstract:

 Objective       To investigate the effect of preoperative radiochemotherapy on proliferation and alteration of primary lesion pathology in esophageal carcinoma. Methods     40 patients with esophageal carcinoma enrolled into this study received biopsy by an esophagoscope prior to treatment and then preoperative adjuvant radiochemotherapy and surgical treatment. Expression of the Ki-67 protein in both biopsy and postoperative specimens was detected by immunohistochemical staining technique. Results     After surgery, 8(20%) patients were detected with tumor regression in a mild degree, 20(50%) in a moderate degree, and 12 (30%) in a severe degree. The overall response rate was 80%. Expression of Ki-67, as a predictive marker of response to preoperative chemoradiotherapy for esophageal cancers, was significantly correlated with tumor regression. Expression of Ki67 was significantly decreased in tumors with severe response to preoperative treatment, when compared to those with moderate and mild responses (P＜0.01). Expression ofKi67 in the slightly shrank group was lower after radiochemotherapy than that before radiochemotherapy, while the difference was not significant (P＞0.05). Conclusion         There are still relict tumor cells after radiochemotherapy in most patients with esophageal carcinoma, about 20% of which are detected without significant tumor regression. Expression level of Ki-67 in esophageal carcinoma tissues significantly descends after radiochemotherapy, which may imply proliferation and invasion of the tumor decrease.

Key words: Esophageal neoplasms; Radiochemotherapy; Pathology response; Ki-67; Proliferation