肝素酶表达鉴别良、恶性腹水无价值

Expression of heparanase mRNA is not a good predictive marker in differential diagnosis of ascites

目的:研究腹水脱落细胞及腹膜活检标本中肝素酶的表达,探讨肝素酶用于鉴别良、恶性腹水的可行性.方法:采用逆转录-聚合酶链反应(RT-PCR)法检测47例腹水脱落细胞中肝素酶mRNA的表达,同时利用免疫组织化学法检测肝素酶蛋白在36例腹膜活检标本中的表达,与相关的临床资料进行分析.结果:肝素酶mRNA在良、恶性腹水脱落细胞中的表达无明显差异(P>0.05).在腹膜活检标本中,肝素酶蛋白不仅存在于腹膜癌细胞中,在结核性腹膜炎上皮样细胞、郎格罕巨细胞、淋巴细胞中及异位的子宫内膜细胞及其间质细胞中均有表达;免疫组织化学法检测腹膜组织中,良、恶性腹水组之间的肝素酶阳性率亦无显著性差异(P>0.05).结论:肝素酶在良性腹水中的高表达可能与腹水脱落细胞中的炎性细胞增高有关.腹水脱落细胞中肝素酶mRNA的表达不能用于良恶性腹水的鉴别.

AIM: To investigate the expression of human heparanase in the peritoneal membrane autopsy specimen and the exfoliative cells of ascites, and to assess its value in the differential diagnosis of malignant and benign ascites. METHODS: Expression of heparanase mRNA in ascites was detected by RT-PCR in forty-seven patients. Heparanase protein expression in 37 biopsies of peritoneum was detected by immunohistochemistry. RESULTS: There was no difference in the expression of heparanase mRNA between benign and malignant ascites (P>0.05). Heparanase protein was expressed not only in tumor cells, but also in activated lymphocytes, epithelioid cells, and Langhans giant cells in tuberculosis peritonitis, as well as the heterotopic endometrium and interstitial cells in endometriosis. In those 36 cases detected by immunohistochemistry, no significant difference was found between benign and malignant ascites (P>0.05). CONCLUSION: High expression of heparanase mRNA in some benign ascites may be due to the increase of inflammatoty cells in the peritoneum. Expression of heparanase mRNA in sedimentation of ascites is not a good predictive marker for the differential diagnosis of benign and malignant ascites.