中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2012年
11期
985-990
,共6页
陈陆霞%孙保存%李筱荣%何彦津%宋国祥
陳陸霞%孫保存%李篠榮%何彥津%宋國祥
진륙하%손보존%리소영%하언진%송국상
脉络膜肿瘤%黑色素瘤%新生血管化,病理性%受体,EphA2%预后
脈絡膜腫瘤%黑色素瘤%新生血管化,病理性%受體,EphA2%預後
맥락막종류%흑색소류%신생혈관화,병이성%수체,EphA2%예후
Choroidal neoplasms%Melanoma%Neovascularization,pathologic%Receptor,EphA2%Prognosis
目的 探讨在脉络膜黑色素瘤中上皮酪氨酸激酶受体A2(EphA2)的表达与血管生成拟态(VM)的关系及其临床病理学意义.方法 回顾性系列病例研究.收集天津医科大学第二附属医院眼科1992年1月至2005年12月56例脉络膜黑色素瘤标本及患者的临床病理学资料.采用免疫组织化学方法检测脉络膜黑色素瘤组织中EphA2的表达情况.经CD31/PAS双重染色证实VM存在,依据有无VM将标本分为VM(+)组和VM(-)组.结合肿瘤细胞EphA2表达的阳性率和染色强度结果综合评估,将标本分为低表达和高表达.采用x2检验和t检验分别分析计数资料和计量资料；Kaplan-Meier法分析不偶组患者的生存时间；Cox比例风险模型分析影响患者预后的因素.结果 56例脉络膜黑色素瘤中有VM 26例,无VM 30例；VM与细胞类型、肿瘤大小、复发与转移有关,差异均有统计学意义(x2 =4.612、5.346、5.213,P=0.036、0.021、0.027).在VM(+)组中EphA2表达的阳性率(92.3％,25/26)高于VM(-)组(70.0％,21/30),差异有统计学意义(t=2.247,P=0.009)；在不同组织学类型肿瘤中EphA2高表达情况依次为:上皮细胞型(10/12),混合型(11/15),梭形细胞型(41.40％),差异有统计学意义(x2 =6.513,P =0.010)；EphA2高表达与肿瘤大小、复发与转移有关,差异有统计学意义(x2 =4.556、8.211,P=0.016、0.005)；Kaplan-Meier生存分析提示,EphA2高表达与低表达患者生存时间的差异有统计学意义(t=9.263,P=0.000)；Cox比例风险模型分析表明,EphA2高表达与VM是影响脉络膜黑色素瘤患者预后的独立危险因素(x2=12.041,P=0.001),且二者呈正相关关系(r =0.412,P＜0.05).结论 EphA2高表达与VM是影响预后的不利因素,EphA2高表达促进了VM形成,且与肿瘤的分化、侵袭、转移密切相关,可作为评估预后的重要指标.
目的 探討在脈絡膜黑色素瘤中上皮酪氨痠激酶受體A2(EphA2)的錶達與血管生成擬態(VM)的關繫及其臨床病理學意義.方法 迴顧性繫列病例研究.收集天津醫科大學第二附屬醫院眼科1992年1月至2005年12月56例脈絡膜黑色素瘤標本及患者的臨床病理學資料.採用免疫組織化學方法檢測脈絡膜黑色素瘤組織中EphA2的錶達情況.經CD31/PAS雙重染色證實VM存在,依據有無VM將標本分為VM(+)組和VM(-)組.結閤腫瘤細胞EphA2錶達的暘性率和染色彊度結果綜閤評估,將標本分為低錶達和高錶達.採用x2檢驗和t檢驗分彆分析計數資料和計量資料；Kaplan-Meier法分析不偶組患者的生存時間；Cox比例風險模型分析影響患者預後的因素.結果 56例脈絡膜黑色素瘤中有VM 26例,無VM 30例；VM與細胞類型、腫瘤大小、複髮與轉移有關,差異均有統計學意義(x2 =4.612、5.346、5.213,P=0.036、0.021、0.027).在VM(+)組中EphA2錶達的暘性率(92.3％,25/26)高于VM(-)組(70.0％,21/30),差異有統計學意義(t=2.247,P=0.009)；在不同組織學類型腫瘤中EphA2高錶達情況依次為:上皮細胞型(10/12),混閤型(11/15),梭形細胞型(41.40％),差異有統計學意義(x2 =6.513,P =0.010)；EphA2高錶達與腫瘤大小、複髮與轉移有關,差異有統計學意義(x2 =4.556、8.211,P=0.016、0.005)；Kaplan-Meier生存分析提示,EphA2高錶達與低錶達患者生存時間的差異有統計學意義(t=9.263,P=0.000)；Cox比例風險模型分析錶明,EphA2高錶達與VM是影響脈絡膜黑色素瘤患者預後的獨立危險因素(x2=12.041,P=0.001),且二者呈正相關關繫(r =0.412,P＜0.05).結論 EphA2高錶達與VM是影響預後的不利因素,EphA2高錶達促進瞭VM形成,且與腫瘤的分化、侵襲、轉移密切相關,可作為評估預後的重要指標.
목적 탐토재맥락막흑색소류중상피락안산격매수체A2(EphA2)적표체여혈관생성의태(VM)적관계급기림상병이학의의.방법 회고성계렬병례연구.수집천진의과대학제이부속의원안과1992년1월지2005년12월56례맥락막흑색소류표본급환자적림상병이학자료.채용면역조직화학방법검측맥락막흑색소류조직중EphA2적표체정황.경CD31/PAS쌍중염색증실VM존재,의거유무VM장표본분위VM(+)조화VM(-)조.결합종류세포EphA2표체적양성솔화염색강도결과종합평고,장표본분위저표체화고표체.채용x2검험화t검험분별분석계수자료화계량자료；Kaplan-Meier법분석불우조환자적생존시간；Cox비례풍험모형분석영향환자예후적인소.결과 56례맥락막흑색소류중유VM 26례,무VM 30례；VM여세포류형、종류대소、복발여전이유관,차이균유통계학의의(x2 =4.612、5.346、5.213,P=0.036、0.021、0.027).재VM(+)조중EphA2표체적양성솔(92.3％,25/26)고우VM(-)조(70.0％,21/30),차이유통계학의의(t=2.247,P=0.009)；재불동조직학류형종류중EphA2고표체정황의차위:상피세포형(10/12),혼합형(11/15),사형세포형(41.40％),차이유통계학의의(x2 =6.513,P =0.010)；EphA2고표체여종류대소、복발여전이유관,차이유통계학의의(x2 =4.556、8.211,P=0.016、0.005)；Kaplan-Meier생존분석제시,EphA2고표체여저표체환자생존시간적차이유통계학의의(t=9.263,P=0.000)；Cox비례풍험모형분석표명,EphA2고표체여VM시영향맥락막흑색소류환자예후적독립위험인소(x2=12.041,P=0.001),차이자정정상관관계(r =0.412,P＜0.05).결론 EphA2고표체여VM시영향예후적불리인소,EphA2고표체촉진료VM형성,차여종류적분화、침습、전이밀절상관,가작위평고예후적중요지표.
Objective To study the correlation of EphA2 protein expression with vesculogenic mimicry(VM),clinicopathological characteristics and prognosis in choroidal melanoma(CM).Methods It was a retrospective case series study.Between January 1992 and December 2005,56 cases of human CM with clinicopathologic data from the Second Hospital of Tianjin Medical University were studied.HE stainings were performed to observe the microcirculation patterns in tumor tissue specimens.VM was found in 26 of the 56 cases using CD31/periodic acid-Schiff(PAS) double staining and transelectron microscopy.All cases were divided into two groups:VM-positive and VM-negative.Immunohistochemical staining was performed on paraffin sections of the 56 cases of CM specimens to investigate the expression of EphA2.According to tumor cells positive rate and staining intensity of the results of evaluation,the specimens were divided into low expression and high expression groups.x2-test and t-test were used to analyzed the enumeration data and measurement data,respectively.Survival analysis was used to further elucidate its correlation with clinicopathological characteristics,VM and prognosis.Cox proportional hazard model was used to analyzed the influence factors of prognosis.Results VM channels were found in 26 of the 56 CM cases and VM-negative 30 cases.VM-positivity was related to cell type,tumor size and recurrence and metastasis,and the differences were statistically significant (x2 =4.612,5.346,5.213 ; P =0.036,0.021,0.027).The results showed that EphA2 was up-regulated in the VM-positive group compared with the group of VM-negative group.The positive rates of EphA2 expression in the VM-positive group and VM-negative group were 92.3％(25/26) and 70.0％ (21/30),respectively,with a significant difference between the two groups (t =2.247,P =0.009).The EphA2 protein was expressed in epithelioid (10/12),mixed (11/15) and spindle (41.40％) cell types,with a significant difference among these histological types (x2 =6.513,P =0.010).The expression rate of EphA2 protein were significantly higher in large (54.55％,18/33) than small (45.45％,15/33) tumors,and the expression of EphA2 in metastastic and recurrence patients (10/11) were significantly higher compared with controls (31.11％,14/45) (x2 =4.556,8.211 ; P =0.016,0.005).Kaplan-Meier survival analysis showed the presence of VM resulted in a poor prognosis (t =9.263,P =0.000).The Cox proportional hazards model indicated that the EphA2 overexpression and the presence of VM were independent predictors of a poor prognosis (x2 =12.041,P =0.001).Moreover,there was a significant positive correlation between them (r =0.412,P ＜ 0.05).Conclusion The results of this study demonstrate that EphA2 may play a critical role in the formation process of VM in CM,implicating EphA2 as a valuable marker for the prediction of recurrence,metastasis and prognosis in CM patients.
