CAJ | 학술논문

目的：观察高迁移率族蛋白A1（the high mobility group A1，HMGA1）在垂体腺瘤的表达特征，探讨其与腺瘤侵袭及复发的关系。方法采用免疫组化方法，分析HMGA1蛋白在侵袭与非侵袭性腺瘤、复发与非复发性腺瘤表达率的差异及相关性。结果52例腺瘤HMGA1均呈阳性表达，信号定位细胞核分布较均匀。 HMGA1蛋白的表达率，在功能性与非功能性腺瘤间（ P＝0.79），不同免疫表型腺瘤间（P＝0.28），表达差异无统计学意义。侵袭与非侵袭性腺瘤（（0.50±0.20） vs（0.24±0.17），P ＝0.000）），复发与非复发性腺瘤（（0.60±0.20）vs（0.24±0.18），P＝0.000）），微腺瘤、大腺瘤与巨大腺瘤（（0.18±0.17）vs（0.40±0.23）vs（0.52±0.20），P＝0.03）），HardyⅠ级、Ⅱ级与Ⅲ-Ⅳ级腺瘤（（0.18±0.17） vs（0.30±0.20） vs（0.50±0.20），P＝0.003））间，差异有统计学意义。 HMGA1预测腺瘤复发的ROC曲线下面积为0.918（＞0.90）。当HMGA1表达率49.2％时，对腺瘤复发预测的特异性达90.5％，敏感度71.4％。结论 HMGA1表达水平与腺瘤的体积、侵袭性及复发显著相关，其预测腺瘤复发风险的准确度较高；HMGA1表达特点有利于病理医师对其准确与可重复性判读。
목적：관찰고천이솔족단백A1（the high mobility group A1，HMGA1）재수체선류적표체특정，탐토기여선류침습급복발적관계。방법채용면역조화방법，분석HMGA1단백재침습여비침습성선류、복발여비복발성선류표체솔적차이급상관성。결과52례선류HMGA1균정양성표체，신호정위세포핵분포교균균。 HMGA1단백적표체솔，재공능성여비공능성선류간（ P＝0.79），불동면역표형선류간（P＝0.28），표체차이무통계학의의。침습여비침습성선류（（0.50±0.20） vs（0.24±0.17），P ＝0.000）），복발여비복발성선류（（0.60±0.20）vs（0.24±0.18），P＝0.000）），미선류、대선류여거대선류（（0.18±0.17）vs（0.40±0.23）vs（0.52±0.20），P＝0.03）），HardyⅠ급、Ⅱ급여Ⅲ-Ⅳ급선류（（0.18±0.17） vs（0.30±0.20） vs（0.50±0.20），P＝0.003））간，차이유통계학의의。 HMGA1예측선류복발적ROC곡선하면적위0.918（＞0.90）。당HMGA1표체솔49.2％시，대선류복발예측적특이성체90.5％，민감도71.4％。결론 HMGA1표체수평여선류적체적、침습성급복발현저상관，기예측선류복발풍험적준학도교고；HMGA1표체특점유리우병리의사대기준학여가중복성판독。
Objective To observe the expression of high mobility group A 1(HMGA1)protein in pituitary adenoma(PA)and explore its relationship with the aggressiveness and recurrence of PA .Methods The labeling index(LI)of HMGA1, detected by immunohistochemistry staining , was compared between aggressive and non-ag-gressive PA, recurrent and non-recurrent PA.Results The expression of HMGA1 were observed in all 52 cases of PA and homogenously distributed in nuclear of tumor cells .The LI of HMGA1 showed no significant difference between functioning and nonfunctioning PA (P=0.79), as well as among different immunophenotypical variants of PA(P=0.28).The expression of HMGA1 was significantly higher in the aggressive PA than in the nonaggres-sive PA(0.50 ±0.20 vs 0.24 ±0.17, P=0.000).Patients with a recurrent PA had a higher value of HMGA 1 than patients with a non-recurrent PA(0.60 ±0.20 vs 0.24 ±0.18, P=0.000).The expression of HMGA1 in-creased stepwise with the tumor size, as the highest was present in macro-sized PA(0.52 ±0.20)and the lowest was in micro-sized PA(0.18 ±0.17).A similar trend was found in Hardy's grade I(0.18 ±0.17),II(0.30 ± 0.20)and III-IV(0.50 ±0.20)(P=0.003).The area under the ROC curve was 0.918(>0.90).When the LI reached 49.2%, the predicting specificity was 90.5%and the sensitivity was 71.4%.Conclusions The LI of HMGA1 has a positive correlation with the tumor size , aggressiveness and recurrence of PA and also has a valua-ble predicting efficacy for PA recurrence .The characteristics of HMGA 1 in PA can help pathologists make repro-ducible evaluation on prognosis of PA .