CAJ | 학술논문

目的寻找与睾丸癌分期和预后相关的分子标志物,以更好地制定临床治疗方案.方法收集1999年1月至2008年5月在中山大学肿瘤防治中心接受睾丸癌根治术治疗的精原细胞瘤(34例)和非精原细胞瘤(66例)石蜡标本,其中临床Ⅰ期64例、Ⅱ期22例、Ⅲ期14例.使用免疫组化方法检测肿瘤组织以及20例同期手术正常睾丸组织中RhoA和血管内皮生长因子受体3(vascular endothelial growth factor receptor-3,VEGFR3)的表达情况.统计学分析睾丸癌组织中RhoA及VEGFR3的表达与睾丸癌分期、病理和预后的关系. 结果患者随访26 ～ 278个月,中位随访时间56个月.RhoA在睾丸癌组织中的高表达率为57％(57/100),高于正常组织的25％(5/20),RhoA表达与睾丸癌临床分期相关(P=0.010).VEGFR3在睾丸癌中的高表达率为51％(51/100),VEGFR3高表达与睾丸癌患者肿瘤复发相关(P=0.021).在Ⅰ期非精原细胞瘤中,RhoA高表达与肿瘤复发相关(P=0.035).在Ⅱ/Ⅲ期非精原细胞瘤中,VEGFR3高表达与肿瘤复发相关(P=0.022). 结论睾丸癌组织中RhoA的表达水平与临床分期呈正相关,RhoA高表达的Ⅰ期非精原细胞瘤容易复发,VEGFR3高表达的Ⅱ/Ⅲ期非精原细胞瘤预后欠佳,需要采用更积极的治疗方案.
목적 심조여고환암분기화예후상관적분자표지물,이경호지제정림상치료방안.방법 수집1999년1월지2008년5월재중산대학종류방치중심접수고환암근치술치료적정원세포류(34례)화비정원세포류(66례)석사표본,기중림상Ⅰ기64례、Ⅱ기22례、Ⅲ기14례.사용면역조화방법검측종류조직이급20례동기수술정상고환조직중RhoA화혈관내피생장인자수체3(vascular endothelial growth factor receptor-3,VEGFR3)적표체정황.통계학분석고환암조직중RhoA급VEGFR3적표체여고환암분기、병리화예후적관계. 결과 환자수방26 ～ 278개월,중위수방시간56개월.RhoA재고환암조직중적고표체솔위57％(57/100),고우정상조직적25％(5/20),RhoA표체여고환암림상분기상관(P=0.010).VEGFR3재고환암중적고표체솔위51％(51/100),VEGFR3고표체여고환암환자종류복발상관(P=0.021).재Ⅰ기비정원세포류중,RhoA고표체여종류복발상관(P=0.035).재Ⅱ/Ⅲ기비정원세포류중,VEGFR3고표체여종류복발상관(P=0.022). 결론 고환암조직중RhoA적표체수평여림상분기정정상관,RhoA고표체적Ⅰ기비정원세포류용역복발,VEGFR3고표체적Ⅱ/Ⅲ기비정원세포류예후흠가,수요채용경적겁적치료방안.
Objective To investigate the potential molecular markers for staging and prognosis of testicular cancer.Methods From January 1999 to May 2008,100 specimens of primary testicular cancer (34 cases were seminoma and 66 were nonseminomatous germ cell tumors,64 patients were clinical stage Ⅰ while 22 were stage Ⅱ and 14 were stage Ⅲ) undergoing orchiectomy and 20 specimens of normal testicular tissues were detected protein expressions of Ras homologue A (RhoA) and vascular endothelial growth factor receptor-3 (VEGFR3) using immunohistochemistry.Results evaluation was based on immunohistochemistry semiquantitative scoring system.Correlations of the expression of RhoA and VEGFR3 to clinicopathological features and prognosis of patients were analyzed.Results Median follow-up period was 56 months (range 26-278 months).The overexpression rate of RhoA protein was significantly higher in testicular cancer than that in normal testicular tissues (57％ versus 25％,P =0.008) and was related with clinical stage (P =0.010).The overexpression of VEGFR3 was correlated to recurrence (P=0.021).Tumor recurrence was associated with the overexpression of RhoA in stage Ⅰ non-seminoma (P=0.035),and with the overexpression of VEGFR3 in stage Ⅱ /Ⅲ non-seminoma (P =0.022).Conclusions Overexpression of RhoA is significantly correlated with clinical stage of testicular cancer and with the recurrence in stage Ⅰ non-seminoma.Overexpression of VEGFR3 predicts a poor prognosis of stage Ⅱ/Ⅲ non-seminoma.Those testicular cancer cases may need more aggressive treatment regimens.