CAJ | 학술논문

目的：研究过氧化物酶体增殖物激活受体γ（PPARγ）在膀胱尿路上皮癌中的表达及临床意义。方法收集武汉大学人民医院病理科2006～2009年有完整临床和病理资料的膀胱尿路上皮癌存档蜡块50例和5例癌旁组织，采用免疫组织化学SP法检测50例膀胱尿路上皮癌和5例癌旁组织中 PPARγ的表达水平。采用 HPIAS‐1000高清晰度彩色病理图文报告管理系统，对PPARγ的表达进行定量分析，并用SPSS 13.0软件对各组免疫组织化学反应阳性颗粒的平均吸光度、阳性面积率做单因素方差分析和SNK（q）检验。结果1）PPARγ的表达在膀胱尿路上皮癌中呈高表达，癌旁组织中呈低表达。膀胱尿路上皮癌与癌旁组织相比，差异有统计学意义（P＜0.05）；2）膀胱尿路上皮癌组织中PPARγ的表达与临床病理特征间的关系：①PPARγ蛋白在原发肿瘤直径≥3 cm组阳性率是72.4％，显著高于直径＜3 cm组33.3％，差异有统计学意义（P＜0.05）。②PPARγ蛋白在有淋巴结转移组阳性率72.7％，显著高于无淋巴结转移组阳性率46.4％，差异有统计学意义（P＜0.05）。③PPARγ蛋白在临床分期T3～4期组阳性率75.0％，显著高于 T1、T2期组41.9％、45.5％，差异有统计学意义（均 P＜0.05）。④PPARγ蛋白在低分化组阳性率为68.2％，显著高于高、中分化组（42.9％），差异有统计学意义（P＜0.05）。结论①PPARγ在膀胱尿路上皮癌的发病和进展中起着重要的调节作用；②PPARγ蛋白表达水平与膀胱尿路上皮癌肿瘤分化程度及病理类型、原发肿瘤直径、淋巴结转移、临床分期均相关，提示PPARγ在膀胱尿路上皮癌的增殖、转移中发挥重要作用。
목적：연구과양화물매체증식물격활수체γ（PPARγ）재방광뇨로상피암중적표체급림상의의。방법수집무한대학인민의원병이과2006～2009년유완정림상화병리자료적방광뇨로상피암존당사괴50례화5례암방조직，채용면역조직화학SP법검측50례방광뇨로상피암화5례암방조직중 PPARγ적표체수평。채용 HPIAS‐1000고청석도채색병리도문보고관리계통，대PPARγ적표체진행정량분석，병용SPSS 13.0연건대각조면역조직화학반응양성과립적평균흡광도、양성면적솔주단인소방차분석화SNK（q）검험。결과1）PPARγ적표체재방광뇨로상피암중정고표체，암방조직중정저표체。방광뇨로상피암여암방조직상비，차이유통계학의의（P＜0.05）；2）방광뇨로상피암조직중PPARγ적표체여림상병리특정간적관계：①PPARγ단백재원발종류직경≥3 cm조양성솔시72.4％，현저고우직경＜3 cm조33.3％，차이유통계학의의（P＜0.05）。②PPARγ단백재유림파결전이조양성솔72.7％，현저고우무림파결전이조양성솔46.4％，차이유통계학의의（P＜0.05）。③PPARγ단백재림상분기T3～4기조양성솔75.0％，현저고우 T1、T2기조41.9％、45.5％，차이유통계학의의（균 P＜0.05）。④PPARγ단백재저분화조양성솔위68.2％，현저고우고、중분화조（42.9％），차이유통계학의의（P＜0.05）。결론①PPARγ재방광뇨로상피암적발병화진전중기착중요적조절작용；②PPARγ단백표체수평여방광뇨로상피암종류분화정도급병리류형、원발종류직경、림파결전이、림상분기균상관，제시PPARγ재방광뇨로상피암적증식、전이중발휘중요작용。
Objective To investigate the expression and clinical significance of peroxisome proliferator activated receptor γ(PPARγ)in bladder urothelial cancer tissues.Methods Parafflin‐embeded specimen of bladder urothelial cancer tissues from 50 cases and normal tissues near the bladder urothelial cancer from 5 cases were harvested from the Pathology Department of the Renmin Hospital of Wuhan University between 2006 and 2009.Those cases had complete pathological and clinical data.The ex‐pression of PPARγ was detected by immunohistochemical SP method.Quantitative analysis of the PPARγ was measured by high definition pathological graphics context report system (HPIAS‐1000).One‐way analysis of variance and SNK (q)tests were used to analyze the mean density and the positive area rate of the immunohistochemical results.All data were processed by SPSS 13.0.Results The expression of PPARγwas significantly higher in bladder urothelial cancer tissues than in para‐carcinoma tis‐sues(P<0.05).Correlation between expression of PPARγ with TNM stag of bladder urothelial cancer was as follows :Positive rate of PPARγin the tissues with primary tumor size ≥3 cm was 72.4% ,significantly higher than 33.3% in the tissues with tumor size <3 cm(P<0.05);positive rate of PPARγin the cases with lymph node metastasis was 72.7% ,significantly higher than 46.4% in the cases without lymph node metastasis(P<0.05);positive rate of PPARγin patients at stage T3‐4 group was 75.0% ,significantly higher than 41.9% and 45.5% in patients at clinical stage T1 and T2(P<0.05);positive rate of PPARγin patients with poor differentiation was 68.2% ,significantly higher than 42.9% in patients with high or middle differentiation group(P<0.05).Conclusion PPARγ plays an important regulating role in the onset and progress of bladder urothelial cancer ;PPARγexpression level was correlated with primary tumor size ,pathological types and differentiation degree ,lymph node me‐tastasis and clinical stage.This result suggested that PPARγ was closely correlated to metastasis of bladder urothelial cancer.