中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2012年
6期
380-383
,共4页
崔迪%韩邦旻%荆翌峰%夏术阶
崔迪%韓邦旻%荊翌峰%夏術階
최적%한방민%형익봉%하술계
膀胱肿瘤%钙黏着糖蛋白类%癌%移行细胞
膀胱腫瘤%鈣黏著糖蛋白類%癌%移行細胞
방광종류%개점착당단백류%암%이행세포
Urinary bladder neoplasms%Cadherins%Carcinoma,transitional cell
目的 研究神经(N)钙黏素蛋白和上皮(E)钙黏素蛋白在膀胱癌中表达变化情况,并进一步研究神经上皮(N-E)钙黏素蛋白转换在预测膀胱癌术后复发及预后判断中的价值.方法 收集2005年上海交通大学附属第一人民医院泌尿外科48例64例次经尿道膀胱肿瘤电切术或膀胱部分切除术后的膀胱癌标本,采用免疫组化SP法检测肿瘤标本中N-钙黏素蛋白和E-钙黏素蛋白的表达.采用x2检验、Logistic回归分析、Kaplan-Meier法、Logrank检验、Cox生存回归分析等统计学方法分析两种钙黏素蛋白以及N-E钙黏素蛋白转换与肿瘤临床病理特征、肿瘤复发和患者生存时间的相关性.结果 64例次膀胱癌中N-钙黏素蛋白阳性表达27例次(42.2％),E-钙黏素蛋白阴性表达16例次(25.0％).N-钙黏素蛋白阳性表达与肿瘤低分化、术后复发间隔期缩短、肿瘤相关总生存期缩短呈正相关(P =0.020、0.017、0.011),与肿瘤临床分期和术后复发无关；E-钙黏素蛋白阴性表达与肿瘤低分化、高临床分期、术后复发、肿瘤相关总生存期缩短呈正相关(P=0.022、0.013、0.036、0.003),与术后复发间隔期无关.N-E钙黏素蛋白转换(N-钙黏素蛋白表达阳性的同时E-钙黏素蛋白表达阴性)与肿瘤低分化、高临床分期、术后复发、复发间隔期缩短和肿瘤相关总生存期缩短呈正相关(P =0.009、0.006、0.050、0.027、0.001).综合N-钙黏素蛋白、E-钙黏素蛋白和N-E钙黏素蛋白转换的Cox生存回归分析显示只有N-E钙黏素蛋白转换可作为影响复发间隔期及肿瘤相关总生存期的独立因素(HR =0.428,95％ CI:0.217～0.845；HR=0.098,95％ CI:0.013 ～0.767).结论 相对于N-钙黏素蛋白和E-钙黏素蛋白,N-E钙黏素蛋白转换是评估膀胱癌术后复发、复发间隔期和肿瘤相关总生存期的更佳预测指标.
目的 研究神經(N)鈣黏素蛋白和上皮(E)鈣黏素蛋白在膀胱癌中錶達變化情況,併進一步研究神經上皮(N-E)鈣黏素蛋白轉換在預測膀胱癌術後複髮及預後判斷中的價值.方法 收集2005年上海交通大學附屬第一人民醫院泌尿外科48例64例次經尿道膀胱腫瘤電切術或膀胱部分切除術後的膀胱癌標本,採用免疫組化SP法檢測腫瘤標本中N-鈣黏素蛋白和E-鈣黏素蛋白的錶達.採用x2檢驗、Logistic迴歸分析、Kaplan-Meier法、Logrank檢驗、Cox生存迴歸分析等統計學方法分析兩種鈣黏素蛋白以及N-E鈣黏素蛋白轉換與腫瘤臨床病理特徵、腫瘤複髮和患者生存時間的相關性.結果 64例次膀胱癌中N-鈣黏素蛋白暘性錶達27例次(42.2％),E-鈣黏素蛋白陰性錶達16例次(25.0％).N-鈣黏素蛋白暘性錶達與腫瘤低分化、術後複髮間隔期縮短、腫瘤相關總生存期縮短呈正相關(P =0.020、0.017、0.011),與腫瘤臨床分期和術後複髮無關；E-鈣黏素蛋白陰性錶達與腫瘤低分化、高臨床分期、術後複髮、腫瘤相關總生存期縮短呈正相關(P=0.022、0.013、0.036、0.003),與術後複髮間隔期無關.N-E鈣黏素蛋白轉換(N-鈣黏素蛋白錶達暘性的同時E-鈣黏素蛋白錶達陰性)與腫瘤低分化、高臨床分期、術後複髮、複髮間隔期縮短和腫瘤相關總生存期縮短呈正相關(P =0.009、0.006、0.050、0.027、0.001).綜閤N-鈣黏素蛋白、E-鈣黏素蛋白和N-E鈣黏素蛋白轉換的Cox生存迴歸分析顯示隻有N-E鈣黏素蛋白轉換可作為影響複髮間隔期及腫瘤相關總生存期的獨立因素(HR =0.428,95％ CI:0.217～0.845；HR=0.098,95％ CI:0.013 ～0.767).結論 相對于N-鈣黏素蛋白和E-鈣黏素蛋白,N-E鈣黏素蛋白轉換是評估膀胱癌術後複髮、複髮間隔期和腫瘤相關總生存期的更佳預測指標.
목적 연구신경(N)개점소단백화상피(E)개점소단백재방광암중표체변화정황,병진일보연구신경상피(N-E)개점소단백전환재예측방광암술후복발급예후판단중적개치.방법 수집2005년상해교통대학부속제일인민의원비뇨외과48례64례차경뇨도방광종류전절술혹방광부분절제술후적방광암표본,채용면역조화SP법검측종류표본중N-개점소단백화E-개점소단백적표체.채용x2검험、Logistic회귀분석、Kaplan-Meier법、Logrank검험、Cox생존회귀분석등통계학방법분석량충개점소단백이급N-E개점소단백전환여종류림상병리특정、종류복발화환자생존시간적상관성.결과 64례차방광암중N-개점소단백양성표체27례차(42.2％),E-개점소단백음성표체16례차(25.0％).N-개점소단백양성표체여종류저분화、술후복발간격기축단、종류상관총생존기축단정정상관(P =0.020、0.017、0.011),여종류림상분기화술후복발무관；E-개점소단백음성표체여종류저분화、고림상분기、술후복발、종류상관총생존기축단정정상관(P=0.022、0.013、0.036、0.003),여술후복발간격기무관.N-E개점소단백전환(N-개점소단백표체양성적동시E-개점소단백표체음성)여종류저분화、고림상분기、술후복발、복발간격기축단화종류상관총생존기축단정정상관(P =0.009、0.006、0.050、0.027、0.001).종합N-개점소단백、E-개점소단백화N-E개점소단백전환적Cox생존회귀분석현시지유N-E개점소단백전환가작위영향복발간격기급종류상관총생존기적독립인소(HR =0.428,95％ CI:0.217～0.845；HR=0.098,95％ CI:0.013 ～0.767).결론 상대우N-개점소단백화E-개점소단백,N-E개점소단백전환시평고방광암술후복발、복발간격기화종류상관총생존기적경가예측지표.
Objective To explore the expression patterns of cadherins (N-cadherin and Ecadherin) in urothelial carcinomas and understand the values of N-E cadherin switch in the predictions of postoperative recurrence and prognosis.Methods The expressions of N-cadherin and E-cadherin were measured by immunohistochemistry in 64 transurethral bladder tumer resection (TURBT) or partial cystectomy samples(48 cases)in 2005 by the method of streptavidin-biotin peroxidase.Results A positive expression of N-cadherin and a negative expression of E-cadherin were noted in 27 (42.2％ ) and 16 (25.0％ ) specimens respectively.Patients with more poorly differentiated bladder cancer were accompanied with a higher expression of N-cadherin and a lower expression of E-cadherin ( both P ＜ 0.05 ).A positive expression of N-cadherin decreased the recurrence-free and cancer-related survival rates while a negative expression of E-cadherin was correlated with a lower cancer-related survival rate ( all P ＜ 0.05 ). No significant association was found between the expression of E-cadherin and the recurrence-free survival rate.Furthermore,the N-E cadherin switch ( a negative expression of E-cadherin and a positive expression of Ncadherin) showed a higher predictive power in both recurrence-free and cancer-related survival according to multivariate analysis(HR =0.428,95％ CI:0.217 - 0.845,HR =0.098,95％ CI:0.013 - 0.767 ).No significant association was found between the expressions of two cadherins and postoperative progression.Conclusion Although the expressions of E-cadherin and N-cadherin appear to be correlated with survival outcomes in bladder cancer,N-E cadherin switch may be a better predicator for postoperative recurrence and cancer-related survival.
