膀胱癌复发的分子及临床病理特征

Molecular and pathological characteristics in recurrent bladder cancer

目的比较初发与复发膀胱癌之间的差异;探讨膀胱癌复发的分子基础及临床病理特征。方法回顾性分析23例初发膀胱癌和37例复发膀胱癌的临床病理特征,应用免疫组化方法检测膀胱癌组织中碱性成纤维细胞生长因子(bFGF)、胰岛素样生长因子-Ⅰ受体(IGF-ⅠR)、增殖细胞核抗原(PCNA)、Fas和P27的表达,并分析与肿瘤复发之间关系。结果初发与复发膀胱癌的病理特征相似,但初发组肿瘤>2cm的比率高,而复发组中肿瘤多发相对多见。初发组均至少合并三种分子表达异常,其中四种异常达65.2%、五种全部异常达39.1%。初发组的bFGF、IGF-ⅠR表达和PCNA指数均显著高于复发组。结论初发与复发膀胱癌在分子表达方面存有一定的差异;多基因异常可能是膀胱肿瘤易复发的分子基础。

Objective To compare the difference between primary and recurrent bladder cancer, and to investigate the molecular basis and clinical pathological characteristics of recurrent bladder cancer. Methods Clinical and pathological characteristics of 23 cases with primary bladder cancer and 37 cases with recurrent bladder cancer were retrospectively analyzed. Immunohistochemistry was adopted to examine the expressions of basic fibroblast growth factor （bFGF）, insulin-like growth factor-Ⅰ receptor （IGF-Ⅰ R）, proliferating cellular nuclear antigen （PCNA）, Fas and P27 in tumor tissues, and to analyze the relationship between molecular expressions and tumor recurrence. Results Pathological characteristics were similar between the primary group and the recurrent group. A higher ratio of tumor diameter （〉2 cm） was found in the primary group,while multifocal tumor was often found in the recurrent group. More than three kinds of molecular abnormal expressions were found in all cases of the primary group, four kinds in 65.2%, and five kinds in 39. 1% of the patients. Expressions of bFGF, IGF-Ⅰ R and PCNA index were significantly higher in the primary group than in the recurrent group. Conclusion There are various different molecular expressions between primary bladder cancer and recurrent bladde cancer. Multigene abnormality is the molecular basis of bladder cancer.