中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2011年
3期
250-255
,共6页
胆囊肿瘤%胆囊炎%胆囊息肉%Eph基因%异黏蛋白
膽囊腫瘤%膽囊炎%膽囊息肉%Eph基因%異黏蛋白
담낭종류%담낭염%담낭식육%Eph기인%이점단백
Gallbladder neoplasms%Cholecystitis%Gallbladder polyp%Ephrin-A7%Metadherin
目的 研究胆囊良恶性病变组织中Eph基因家族A7(EphA7)和异黏蛋白(MTDH)表达水平及其临床病理意义.方法 收集1996年6月至2006年6月收治的108例胆囊腺癌、46例癌旁组织、15例腺瘤性息肉和35例慢性胆囊炎患者手术切除标本常规制作石蜡包埋切片.应用EnVision免疫组化法检测其中EphA7和MTDH水平并分析其临床意义.结果 胆囊腺癌EphA7和MTDH表达阳性率明显高于癌旁组织(χ2EphA7=12.65,χ2MTDH=13.00;P＜0.01)、腺瘤性息肉组织(χ2EphA7=8.21,χ2MTDH=9.39;P＜0.01)和慢性胆囊炎组织(χ2EphA7=21.21,χ2MTDH=23.68;P＜0.01);EphA7和(或)MTDH表达阳性的良性病例的胆囊上皮均呈中至重度不典型增生.高分化、肿块最大径＜2 cm、无淋巴结转移、未侵犯周围组织的病例EphA7和MTDH表达阳性率明显低于低分化、肿块最大径≥2 cm(χ2EphA7=5.22,χ2MTDH=5.00;P＜0.05)、淋巴结转移(χ2EphA7=5.15,χ2MTDH=5.86;P＜0.05)和侵犯周围组织(χ2EphA7=7.06,P＜0.01;χ2MTDH=4.13,P＜0.05)的病例;EphA7和MTDH在胆囊腺癌中表达水平呈高度一致性(χ2=13.11,P＜0.01).经Kaplan-Meier生存分析发现EphA7和MTDH表达阳性病例术后生存期明显低于阴性表达病例(PEphA2=0.023,PMTDH=0.034);Cox多变量回归分析显示EphA7和(或)MTDH阳性表达(PEphA2=0.023,PMTDH=0.034)是反映胆囊腺癌预后不良的一个重要指标.结论 EphA7和MTDH表达与胆囊腺癌发生、进展、临床生物学行为及预后有密切关系,EphA7和MTDH阳性表达者预后不良.
目的 研究膽囊良噁性病變組織中Eph基因傢族A7(EphA7)和異黏蛋白(MTDH)錶達水平及其臨床病理意義.方法 收集1996年6月至2006年6月收治的108例膽囊腺癌、46例癌徬組織、15例腺瘤性息肉和35例慢性膽囊炎患者手術切除標本常規製作石蠟包埋切片.應用EnVision免疫組化法檢測其中EphA7和MTDH水平併分析其臨床意義.結果 膽囊腺癌EphA7和MTDH錶達暘性率明顯高于癌徬組織(χ2EphA7=12.65,χ2MTDH=13.00;P＜0.01)、腺瘤性息肉組織(χ2EphA7=8.21,χ2MTDH=9.39;P＜0.01)和慢性膽囊炎組織(χ2EphA7=21.21,χ2MTDH=23.68;P＜0.01);EphA7和(或)MTDH錶達暘性的良性病例的膽囊上皮均呈中至重度不典型增生.高分化、腫塊最大徑＜2 cm、無淋巴結轉移、未侵犯週圍組織的病例EphA7和MTDH錶達暘性率明顯低于低分化、腫塊最大徑≥2 cm(χ2EphA7=5.22,χ2MTDH=5.00;P＜0.05)、淋巴結轉移(χ2EphA7=5.15,χ2MTDH=5.86;P＜0.05)和侵犯週圍組織(χ2EphA7=7.06,P＜0.01;χ2MTDH=4.13,P＜0.05)的病例;EphA7和MTDH在膽囊腺癌中錶達水平呈高度一緻性(χ2=13.11,P＜0.01).經Kaplan-Meier生存分析髮現EphA7和MTDH錶達暘性病例術後生存期明顯低于陰性錶達病例(PEphA2=0.023,PMTDH=0.034);Cox多變量迴歸分析顯示EphA7和(或)MTDH暘性錶達(PEphA2=0.023,PMTDH=0.034)是反映膽囊腺癌預後不良的一箇重要指標.結論 EphA7和MTDH錶達與膽囊腺癌髮生、進展、臨床生物學行為及預後有密切關繫,EphA7和MTDH暘性錶達者預後不良.
목적 연구담낭량악성병변조직중Eph기인가족A7(EphA7)화이점단백(MTDH)표체수평급기림상병리의의.방법 수집1996년6월지2006년6월수치적108례담낭선암、46례암방조직、15례선류성식육화35례만성담낭염환자수술절제표본상규제작석사포매절편.응용EnVision면역조화법검측기중EphA7화MTDH수평병분석기림상의의.결과 담낭선암EphA7화MTDH표체양성솔명현고우암방조직(χ2EphA7=12.65,χ2MTDH=13.00;P＜0.01)、선류성식육조직(χ2EphA7=8.21,χ2MTDH=9.39;P＜0.01)화만성담낭염조직(χ2EphA7=21.21,χ2MTDH=23.68;P＜0.01);EphA7화(혹)MTDH표체양성적량성병례적담낭상피균정중지중도불전형증생.고분화、종괴최대경＜2 cm、무림파결전이、미침범주위조직적병례EphA7화MTDH표체양성솔명현저우저분화、종괴최대경≥2 cm(χ2EphA7=5.22,χ2MTDH=5.00;P＜0.05)、림파결전이(χ2EphA7=5.15,χ2MTDH=5.86;P＜0.05)화침범주위조직(χ2EphA7=7.06,P＜0.01;χ2MTDH=4.13,P＜0.05)적병례;EphA7화MTDH재담낭선암중표체수평정고도일치성(χ2=13.11,P＜0.01).경Kaplan-Meier생존분석발현EphA7화MTDH표체양성병례술후생존기명현저우음성표체병례(PEphA2=0.023,PMTDH=0.034);Cox다변량회귀분석현시EphA7화(혹)MTDH양성표체(PEphA2=0.023,PMTDH=0.034)시반영담낭선암예후불량적일개중요지표.결론 EphA7화MTDH표체여담낭선암발생、진전、림상생물학행위급예후유밀절관계,EphA7화MTDH양성표체자예후불량.
Objective To study the expression of ephrin-A7(EphA7)and metadherin(MTDH)and their clinicopathological significances in the benign and malignant lesions of gallbladder. Methods EnVisiom immunohistochemical methods was used for determining the expressions of EphA7 and MTDH in routinely paraffin-embedded sections of surgically-resected specimens from 108 cases with gallbladder adenocarcinoma, 15 cases with adenomatous polyp and 35 cases with chronic cholecystitis treated from June 1996 to June 2006. And 46 cases of peritumoral tissues were also harvested as controls(n = 35). Results The positive expression rates of EphA7 and MTDH were significantly higher in gallbladder adenocarcinoma than those in peritumoral tissues(χ2EphA7 = 12. 65 ,χ2MTDH = 13.00; P ＜0. 01), adenomatous polyp(χ2EphA7 =8. 21 ,χ2MTDH = 9. 39; P ＜ 0. 01)and chronic cholecystitis(χ2EphA7 =21.21 χ2MTDH =23.68 P＜0. 01);Moderately-or severely-atypical hyperplasia of gallbladder epitheli was found in the benign lesions with positive expression of EphA7 and/or MTDH. The positive rates of EphA7 and MTDH were significanctly lower in the cases of well-differentiated adenocarcinoma, maximal diameter of tumor ＜ 2 cm, no-metastasis of lymph node, and tumor with no-invasiveness of regional tissues than those in the poorly-differentiated adenocaarcinoma(χ2EphA7 =12.34,χ2MTDH =12.80; P＜0. 01)maximal diameter of tumor ≥2 cm(χ2EphA7=5.22,χ2MTDH =5.00; P＜0. 05)cases with metastasis of lymph node(χ2EphA7 =5.15 x2MTDH =5.86;P＜0. 05)and cases with invasiveness of regional tissues(χ2EphA72 =7.06, P＜0.01; χ2MTDH =4.13; P＜0.05)in gallbladder adenocarcinoma(P ＜ 0. 05). The high consistence was found between the expressive levels of EphA7 and MTDH in gallbladder adenocarcinoma(χ2 = 13.11, P ＜0. 01). The univariate KaplanMeier analysis showed that the increased expression of EphA7(P = 0. 023)and MTDH(P = 0. 034)was negatively associated with the overall survival. The multivariate Cox regression analysis showed that increased expression of EphA7 and/or MTDH(PEphA2 = 0. 023, PMTDH = 0. 034)was an independent poor-prognostic predictor for gallbladder adenocarcinoma. Conclusions The expression of EphA7 and/or MTDH might be closely related to the carcinogenesis, progression, clinical biological behaviors and prognosis of gallbladder adenocarcinoma. The positive expression of EphA7 and/or MTDH may predict bad-prognosis in gallbladder adenocarcinoma.
