CAJ | 학술논문

目的探讨连接素-β(β-catenin)和雌激素受体(ER)在韧带样型纤维瘤病中的表达及意义.方法采用免疫组织化学染色法检测77例韧带样型纤维瘤病和171例其它良、恶性梭形细胞病变(包括结节性筋膜炎36例、浅部纤维瘤病11例、瘢痕疙瘩16例、增生性瘢痕10例、肉芽组织9例、滑膜肉瘤38例、神经纤维瘤13例、孤立性纤维性肿瘤12例,胃肠间质肿瘤10例、低度恶性黏液纤维肉瘤3例、低度恶性纤维黏液样肉瘤3例及平滑肌肿瘤10例)组织中β-catenin核阳性的表达,同时检测韧带样型纤维瘤病中ER-α、ER-β和Ki-67的表达.β-catenin、ER-α、ER-β表达水平按阳性表达率分级,表达率≥25%为高水平表达,表达率5%～25%为低水平表达,表达率＜5%为阴性.结果 β-catenin高水平核阳性表达仅见于70.1%的韧带样型纤维瘤病(54/77)和6.3%的瘢痕疙瘩(1/16).在其它类型病变中未见高水平阳性表达.韧带样型纤维瘤病中ER-α表达率为0,而80.5%(62/77)的病例表达ER-β,ER-β高水平与低水平表达阳性率分别为67.5%(52/77)和13.0%(10/77).β-catenin与ER-β在韧带样型纤维瘤病中的表达呈正相关(r=0.867,P＜0.05).韧带样型纤维瘤病中Ki-67阳性率非常低.β-catenin、ER-β和Ki-67的表达水平均不是影响预后(复发)的独立危险因素.结论高水平β-catenin核阳性表达可用于辅助韧带样型纤维瘤病诊断以及与其它梭形细胞肿瘤的鉴别诊断.β-catenin与ER-β间可能存在相互作用.β-catenin、ER-β和Ki-67均不能作为韧带样型纤维瘤病的预后指标.
목적 탐토련접소-β(β-catenin)화자격소수체(ER)재인대양형섬유류병중적표체급의의.방법 채용면역조직화학염색법검측77례인대양형섬유류병화171례기타량、악성사형세포병변(포괄결절성근막염36례、천부섬유류병11례、반흔흘탑16례、증생성반흔10례、육아조직9례、활막육류38례、신경섬유류13례、고립성섬유성종류12례,위장간질종류10례、저도악성점액섬유육류3례、저도악성섬유점액양육류3례급평활기종류10례)조직중β-catenin핵양성적표체,동시검측인대양형섬유류병중ER-α、ER-β화Ki-67적표체.β-catenin、ER-α、ER-β표체수평안양성표체솔분급,표체솔≥25%위고수평표체,표체솔5%～25%위저수평표체,표체솔＜5%위음성.결과 β-catenin고수평핵양성표체부견우70.1%적인대양형섬유류병(54/77)화6.3%적반흔흘탑(1/16).재기타류형병변중미견고수평양성표체.인대양형섬유류병중ER-α표체솔위0,이80.5%(62/77)적병례표체ER-β,ER-β고수평여저수평표체양성솔분별위67.5%(52/77)화13.0%(10/77).β-catenin여ER-β재인대양형섬유류병중적표체정정상관(r=0.867,P＜0.05).인대양형섬유류병중Ki-67양성솔비상저.β-catenin、ER-β화Ki-67적표체수평균불시영향예후(복발)적독립위험인소.결론 고수평β-catenin핵양성표체가용우보조인대양형섬유류병진단이급여기타사형세포종류적감별진단.β-catenin여ER-β간가능존재상호작용.β-catenin、ER-β화Ki-67균불능작위인대양형섬유류병적예후지표.
Objective To detect the expression of p-catenin and Estrogen Receptor in desmoid-type fibromatosis.Methods Nuclear p-catenin expression was detected by immunohistochemistry in 77 lesions with desmoid-type fibromatosis and 171 other spindle cell lesions,including superficial fibrmoatosis(n=18),nodular fasciitis(n=36),keloid(n=16),scar(n=10),granulation tissue(n=9),synovial sarcoma(n=38),neufibroma(n=13),solitary fibrous tumor(n=12),gastrointestinal stromal tumor(n=10),low-grade myxofibrosarcoma(n=3),low-grade fibromyxoid sarcoma(n=3),and smooth muscle tumor(n=10).In addition,the immunohistochemical expressions of ER-α,ER-β and Ki-67 were examined in all of the lesions with desmoid-type fibromatosis.The nuclear immunohistochemical staining for nuclear β-catenin and ER-β was graded as high level(≥25%of cells),low level(5%-25%)or none.Results High-level nuclear β-catenin staining was detected in a very limited subset of tissue types,which included 70.1%of lesions with desmoid-type fibromatosis(54/77)and 6.3%of lesions with keloid(1/16).No high-level nuclear β-catenin staining was seen in any of the other lesions.None of the lesions with desmoid-type fibromatosis expressed ER-α.However,62(80.5%)of the lesions with desmoids-type fbromatosis were positive in ER-β,which included 52(67.5%)with high-level expression,and 10(13%)with low-level expression.The Spearman correlation analysis suggested that the expression of β-catenin was positively correlated(r=0.867,P＜0.05)with the expression of ER-β.The lesions with desmoid-type fibromatosis had very low Ki-67 positive rate.The recurrence of desmoids-type fibromatosis was not correlated independently with β-catenin,ER-β or Ki-67.Conclnsion High-level nuclear β-catenin staining serves as a useful diagnostic tool for desmoid-type fibromatosis.The high expression of ER-β in desmoid-type fibromatosis provides a biological mechanism for the antiestrogenic compounds to treat fibromatosis.There might exists an interaction between β-catenin and ER-β.β-catenin,ER-β or Ki-67 can not predict the prognosis of desmoid-type fibromatosis.