中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2011年
2期
177-180
,共4页
赵伟%孙茸%赵守国%赵南
趙偉%孫茸%趙守國%趙南
조위%손용%조수국%조남
膀胱尿路上皮癌%胸苷酸合成酶%预后
膀胱尿路上皮癌%胸苷痠閤成酶%預後
방광뇨로상피암%흉감산합성매%예후
Bladder urothelial carcinoma%Thymidylate synthase%Prognosis
目的 探讨胸苷酸合成酶(TS)在膀胱尿路上皮癌(BUC)的表达情况及临床意义,评价TS预后价值,为肿瘤预后判断及治疗方案的选择提供帮助.方法 采用免疫组织化学染色(SP法)的方法检测54例BUC组织及15例正常膀胱组织的TS表达,通过回顾性随访,了解患者术后情况.以TS表达水平、临床病理变量及两个预后变量[无复发生存率(RFS)和总生存率(OS)]作为研究对象,探讨它们之间的关系,绘制生存曲线,进行Cox回归分析.结果 54例肿瘤标本中TS高表达率为46.30%(25/54),其中G1级为29.41%(5/17),G2级为46.43%(13/28),G3级为77.78%(7/9);Ta期为21.43%(3/14),T1期为26.32%(5/19),T2期为86.67%(13/15),T3期为66.67%(2/3),T4期为66.67%(2/3);TS表达水平与肿瘤分级、分期呈正相关(Kruskal-Wallis H,P=0.03,P＜0.001).TS高表达患者术后复发率、病死率分别为60.00%(15/25)和44.00%(11/25),经生存分析和Cox回归分析,肿瘤的TS表达水平是术后复发(RR为2.65,95%CI 0.80～8.81,P＜0.05)、死亡(RR为1.42,95%CI0.36～5.58,P＜0.05)的独立预后因素.结论 随着TS表达水平升高,BUC发生恶性进展和复发的概率增加,测定其表达水平有助于选择恰当的治疗和随访方案.
目的 探討胸苷痠閤成酶(TS)在膀胱尿路上皮癌(BUC)的錶達情況及臨床意義,評價TS預後價值,為腫瘤預後判斷及治療方案的選擇提供幫助.方法 採用免疫組織化學染色(SP法)的方法檢測54例BUC組織及15例正常膀胱組織的TS錶達,通過迴顧性隨訪,瞭解患者術後情況.以TS錶達水平、臨床病理變量及兩箇預後變量[無複髮生存率(RFS)和總生存率(OS)]作為研究對象,探討它們之間的關繫,繪製生存麯線,進行Cox迴歸分析.結果 54例腫瘤標本中TS高錶達率為46.30%(25/54),其中G1級為29.41%(5/17),G2級為46.43%(13/28),G3級為77.78%(7/9);Ta期為21.43%(3/14),T1期為26.32%(5/19),T2期為86.67%(13/15),T3期為66.67%(2/3),T4期為66.67%(2/3);TS錶達水平與腫瘤分級、分期呈正相關(Kruskal-Wallis H,P=0.03,P＜0.001).TS高錶達患者術後複髮率、病死率分彆為60.00%(15/25)和44.00%(11/25),經生存分析和Cox迴歸分析,腫瘤的TS錶達水平是術後複髮(RR為2.65,95%CI 0.80～8.81,P＜0.05)、死亡(RR為1.42,95%CI0.36～5.58,P＜0.05)的獨立預後因素.結論 隨著TS錶達水平升高,BUC髮生噁性進展和複髮的概率增加,測定其錶達水平有助于選擇恰噹的治療和隨訪方案.
목적 탐토흉감산합성매(TS)재방광뇨로상피암(BUC)적표체정황급림상의의,평개TS예후개치,위종류예후판단급치료방안적선택제공방조.방법 채용면역조직화학염색(SP법)적방법검측54례BUC조직급15례정상방광조직적TS표체,통과회고성수방,료해환자술후정황.이TS표체수평、림상병리변량급량개예후변량[무복발생존솔(RFS)화총생존솔(OS)]작위연구대상,탐토타문지간적관계,회제생존곡선,진행Cox회귀분석.결과 54례종류표본중TS고표체솔위46.30%(25/54),기중G1급위29.41%(5/17),G2급위46.43%(13/28),G3급위77.78%(7/9);Ta기위21.43%(3/14),T1기위26.32%(5/19),T2기위86.67%(13/15),T3기위66.67%(2/3),T4기위66.67%(2/3);TS표체수평여종류분급、분기정정상관(Kruskal-Wallis H,P=0.03,P＜0.001).TS고표체환자술후복발솔、병사솔분별위60.00%(15/25)화44.00%(11/25),경생존분석화Cox회귀분석,종류적TS표체수평시술후복발(RR위2.65,95%CI 0.80～8.81,P＜0.05)、사망(RR위1.42,95%CI0.36～5.58,P＜0.05)적독립예후인소.결론 수착TS표체수평승고,BUC발생악성진전화복발적개솔증가,측정기표체수평유조우선택흡당적치료화수방방안.
Objective To investigate the expression of thymidylate synthase (TS) in bladder urothelial carcinoma(BUC) and its clinical significance, and to evaluate its prognostic value, thus to help predict the prognosis and choose therapy protocal. Methods The expression of TS was assessed by immunohistochemistry in 54 BUC and 15 normal bladder specimens, and all these clinical data were retrospectively analyzed after surgery. Expression of TS,clinicopathologic findings and two prognostic variances (relapse-free survival (RFS) and overall survival (OS)) were determined. The prognostic value of TS was estimated by survival curve and Cox proportional hazards model. Results Immunohistochemistry showed that 25 of 54 BUC cases (46. 30%) had high TS expression. In these cases,there was 29. 41%o (5/17) for G1 ,46. 43% (13/28) for G2,77. 78% (7/9) for G3 ;21.43% (3/14) for Ta, 26. 32% (5/19) for T1, 86. 67% ( 13/15 ) for T2,66.67% (2/3) for T3,66.67% (2/3) for T4. Expression of TS was positively associated with the grade and stage of carcinorma ( Kruskal - Wallis H, P = 0. 0 3 and P ＜ 0. 0 0 1 ). The recurrence and case - fatality of patients with high TS expression was 60. 00% (15/25) and 44. 00% (11/25) ,respectively. The survival analysis and Cox regression analysis showed that expression of TS were independent predictor for recurrence ( RR = 2. 65,95% CI was 0.80～8.81,P＜0.05) anddeath (RR=1.42,95%CIwas0. 36～5.58,P＜0. 05). Conclusions The probability of BUC progress and recurrence increases with the increasing of TS expression. Detection of TS expressing level can contribute to select appropriate treatment and follow-up schema.
