CAJ | 학술논문

目的：探讨Wnt信号通路激活在肝门部胆管癌发生中的作用。方法回顾性分析1998年7月至2007年5月在中山大学附属第一医院行手术切除治疗的129例肝门部胆管癌及45例先天性胆总管囊肿患者临床资料。其中肝门部胆管癌患者男91例，女38例；平均年龄（56±23）岁。先天性胆总管囊肿患者男32例，女13例；年龄（39±11）岁。所有患者均签署知情同意书，符合医学伦理学规定。制作患者病理标本的组织芯片，对Wnt信号蛋白（Wnt）-2、β-链蛋白（β-catenin）、T细胞因子-4（TCF-4）蛋白进行免疫组化染色。以Wnt-2、β-catenin和TCF-43个指标同时阳性表达为Wnt信号通路激活。两组率的比较采用χ2检验。结果免疫组织染色结果显示，肝门部胆管癌组织Wnt-2阳性表现为细胞浆出现棕黄色颗粒，β-catenin、TCF-4阳性表现为细胞核出现棕黄色颗粒。肝门部胆管癌组织中Wnt-2、β-catenin和TCF-43个指标同时阳性表达的发生率为54%（70/129），明显高于先天性胆管囊肿的29%（13/45）（χ2=11.2，P<0.05）。结论 Wnt信号通路激活可能是肝门部胆管癌发生的重要分子生物学机制之一。
목적：탐토Wnt신호통로격활재간문부담관암발생중적작용。방법회고성분석1998년7월지2007년5월재중산대학부속제일의원행수술절제치료적129례간문부담관암급45례선천성담총관낭종환자림상자료。기중간문부담관암환자남91례，녀38례；평균년령（56±23）세。선천성담총관낭종환자남32례，녀13례；년령（39±11）세。소유환자균첨서지정동의서，부합의학윤리학규정。제작환자병리표본적조직심편，대Wnt신호단백（Wnt）-2、β-련단백（β-catenin）、T세포인자-4（TCF-4）단백진행면역조화염색。이Wnt-2、β-catenin화TCF-43개지표동시양성표체위Wnt신호통로격활。량조솔적비교채용χ2검험。결과면역조직염색결과현시，간문부담관암조직Wnt-2양성표현위세포장출현종황색과립，β-catenin、TCF-4양성표현위세포핵출현종황색과립。간문부담관암조직중Wnt-2、β-catenin화TCF-43개지표동시양성표체적발생솔위54%（70/129），명현고우선천성담관낭종적29%（13/45）（χ2=11.2，P<0.05）。결론 Wnt신호통로격활가능시간문부담관암발생적중요분자생물학궤제지일。
ObjectiveTo investigate the effect of Wnt signaling pathway activated on occurrence of hilar cholangiocarcinoma.MethodsClinical data of 129 patients with hilar cholangiocarcinoma and 45 patients with congenital choledochal cyst undergoing surgical resection in the First Afifliated Hospital of Sun Yat-sen University between July 1998 and May 2007 were retrospectively studied. Among the 129 patients with hilar cholangiocarcinoma, 91 were males and 38 were females with the average age of (56±23) years old. Among the 45 patients with congenital choledochal cyst, 32 were males and 13 were females with the average age of (39±11) years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. The tissue microarray of the pathological specimen was made. Wnt signal protein (Wnt) -2, β-catenin and T cell factor-4 (TCF-4) were treated by immunohistochemical staining. The positive expression of 3 indexes Wnt-2, β-catenin and TCF-4 observed simultaneously was considered as activated Wnt signaling pathway. The rate comparison of two groups was conducted using chi-square test.ResultsAccording to results of immunohistochemical staining,the positive expression of Wnt-2 in hilar cholangiocarcinoma tissues was observed in the appearance of brown granules in cytoplasm, while the positive expression of β-catenin and TCF-4 was observed in the appearance of brown granules in cell nucleus. The incidence of simultaneous positive expression of the 3 indexes Wnt-2, β-catenin and TCF-4 in hilar cholangiocarcinoma tissues was 54% (70/129), which was signiifcantly higher than 29% (13/45) in congenital choledochal cyst (χ2=11.2,P<0.05).ConclusionThe activation of Wnt signaling pathway may be one of the important molecular biological mechanisms of the occurrence of hilar cholangiocarcinoma.