中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2009年
12期
1024-1028
,共5页
吴海燕%沈晓辉%倪荣生%钱晓云%高下
吳海燕%瀋曉輝%倪榮生%錢曉雲%高下
오해연%침효휘%예영생%전효운%고하
喉肿瘤%钙黏着糖蛋白类%尿纤溶酶原激活物%预后
喉腫瘤%鈣黏著糖蛋白類%尿纖溶酶原激活物%預後
후종류%개점착당단백류%뇨섬용매원격활물%예후
Laryngeal neoplasms%Cadherins%Urinary plasminogen%Prognosis
目的 研究喉癌组织中细胞黏附分子E-cadherin(ECD)和尿激酶型纤溶酶原激活剂(urokinase-type plasminogen activator,uPA)的表达及其在喉癌患者临床预后评估中的价值.方法 采用免疫组化Envision二步法分别检测ECD、uPA在51例喉癌切除标本组织中的表达情况并结合临床随访,分析其与临床病理参数及患者预后的关系.结果 ECD在51例喉癌中阴性表达24例(47.1%),uPA阳性表达26例(51.0%),ECD的表达缺失或下降、uPA的高表达与喉癌的淋巴转移有关(X~2值分别为5.545和5.790,P值分别为0.019和0.016).ECD阳性者生存率为74.1%,ECD阴性者生存率为54.2%,两者差异无统计学意义(X~2=2.534,P＞0.05).uPA阳性者生存率为50.0%,uPA阴性者生存率为80.0%,两者差异有统计学意义(X~2=6.259,P＜0.05).按照二者表达的不同分为4组:ECD(-)/uPA(-)、ECD(+)/uPA(-)、ECD(-)/uPA(+)、ECD(+)/uPA(+),ECD(-)/uPA(+)组与另外3组比较,有明显的淋巴转移倾向(X~2=11.937,P=0.008).ECD(+)/uPA(-)组生存率为78.6%,ECD(-)/uPA(+)组患者生存率为30.8%,两组差异有统计学意义(X~2=6.559,P=0.01).Cox多因素回归分析显示,ECD和uPA的表达及临床分期是影响患者预后的独立因素.结论 ECD和uPA表达的联合分析可有助于评估喉癌发生转移的危险性,并有助于为评估临床预后提供参考.
目的 研究喉癌組織中細胞黏附分子E-cadherin(ECD)和尿激酶型纖溶酶原激活劑(urokinase-type plasminogen activator,uPA)的錶達及其在喉癌患者臨床預後評估中的價值.方法 採用免疫組化Envision二步法分彆檢測ECD、uPA在51例喉癌切除標本組織中的錶達情況併結閤臨床隨訪,分析其與臨床病理參數及患者預後的關繫.結果 ECD在51例喉癌中陰性錶達24例(47.1%),uPA暘性錶達26例(51.0%),ECD的錶達缺失或下降、uPA的高錶達與喉癌的淋巴轉移有關(X~2值分彆為5.545和5.790,P值分彆為0.019和0.016).ECD暘性者生存率為74.1%,ECD陰性者生存率為54.2%,兩者差異無統計學意義(X~2=2.534,P＞0.05).uPA暘性者生存率為50.0%,uPA陰性者生存率為80.0%,兩者差異有統計學意義(X~2=6.259,P＜0.05).按照二者錶達的不同分為4組:ECD(-)/uPA(-)、ECD(+)/uPA(-)、ECD(-)/uPA(+)、ECD(+)/uPA(+),ECD(-)/uPA(+)組與另外3組比較,有明顯的淋巴轉移傾嚮(X~2=11.937,P=0.008).ECD(+)/uPA(-)組生存率為78.6%,ECD(-)/uPA(+)組患者生存率為30.8%,兩組差異有統計學意義(X~2=6.559,P=0.01).Cox多因素迴歸分析顯示,ECD和uPA的錶達及臨床分期是影響患者預後的獨立因素.結論 ECD和uPA錶達的聯閤分析可有助于評估喉癌髮生轉移的危險性,併有助于為評估臨床預後提供參攷.
목적 연구후암조직중세포점부분자E-cadherin(ECD)화뇨격매형섬용매원격활제(urokinase-type plasminogen activator,uPA)적표체급기재후암환자림상예후평고중적개치.방법 채용면역조화Envision이보법분별검측ECD、uPA재51례후암절제표본조직중적표체정황병결합림상수방,분석기여림상병리삼수급환자예후적관계.결과 ECD재51례후암중음성표체24례(47.1%),uPA양성표체26례(51.0%),ECD적표체결실혹하강、uPA적고표체여후암적림파전이유관(X~2치분별위5.545화5.790,P치분별위0.019화0.016).ECD양성자생존솔위74.1%,ECD음성자생존솔위54.2%,량자차이무통계학의의(X~2=2.534,P＞0.05).uPA양성자생존솔위50.0%,uPA음성자생존솔위80.0%,량자차이유통계학의의(X~2=6.259,P＜0.05).안조이자표체적불동분위4조:ECD(-)/uPA(-)、ECD(+)/uPA(-)、ECD(-)/uPA(+)、ECD(+)/uPA(+),ECD(-)/uPA(+)조여령외3조비교,유명현적림파전이경향(X~2=11.937,P=0.008).ECD(+)/uPA(-)조생존솔위78.6%,ECD(-)/uPA(+)조환자생존솔위30.8%,량조차이유통계학의의(X~2=6.559,P=0.01).Cox다인소회귀분석현시,ECD화uPA적표체급림상분기시영향환자예후적독립인소.결론 ECD화uPA표체적연합분석가유조우평고후암발생전이적위험성,병유조우위평고림상예후제공삼고.
Objective To investigate the expression of E-cadherin(ECD)and uPA in laryngeal cancer and evaluate their clinical value in prognosis.Methods ECD and uPA were determined by immunohistochemistry of Envision methods in carcinoma tissues of 51 patients of laryngeal carcinoma.All patients were followed and the prognostic factors were analyzed.Results Among 51 patients'tumor tissues,24(47.1%)were negative expression of ECD,and 26(51.0%)were positive uPA immunoreaction was observed.There were four subgroups of patterns of ECD and uPA expression:14(27.1 %)ECD-positive/uPA-negative,13(25.5%)ECD-negative/uPA-negative,11(21.6%)ECD-positive/uPA-positive,and 13(25.5%)ECD-negative /uPA-positive.The tumor tissues with ECD-negative and uPA-positive expression were significant associated with lymph nodes metastasis(X~2=5.545,5.79,P=0.019,0.016 respectively).Patients with ECD-negative expression had a shorter survival than the patients with ECD positive expression but no statistic difference(X~2=2.534,P＞0.05).Patients with uPA-positive expression had a significantly shorter survival time than those with uPA-negative expression(X~2=6.259,P＜0.05).There was a difference for the median survival time between the patients with uPA-negative/ECD-positive and the patients with uPA-positive/ECD-negative in laryngeal cancer tissue(X~2=6.559,P=0.01),and the survival curves between these two groups was also statistically significant difference.Multivariate analysis of Cox revealed that clinical stage and ECD/uPA(P=0.009,0.007 respectively)were two independent prognostic factors.Conclusions The combination analysis of uPA and ECD immunohistochemical expression in the laryngeal cancer tissue may be useful for predicting tumor metastatic risks and patient's prognosis.
