DNA拓扑异构酶Ⅱα的表达与颅咽管瘤预后的关系

Relationship between DNA topoisomerase Ⅱ alpha expression and prognosis in craniopharyngiomas

目的检测颅咽管瘤组织中DNA拓扑异构酶Ⅱα(DNATopoⅡα)的表达情况,分析其表达与肿瘤复发的关系,探讨其是否可作为判定颅咽管瘤预后的一个有效指标。方法设计前瞻性队列研究方案,采用免疫组化方法和图像分析技术测定63例颅咽管瘤组织切片中DNA拓扑异构酶Ⅱα的表达水平,评价颅咽管瘤釉质上皮瘤与鳞状乳头瘤病理亚型、复发组与非复发组、原发组与复发组之间肿瘤细胞的增殖能力。结果32例釉质上皮瘤14例复发,31例鳞状乳头瘤6例复发;釉质上皮瘤与鳞状乳头瘤病理亚型之间以及复发组与非复发组肿瘤之间DNA拓扑异构酶Ⅱα的表达水平有显著性差异(P<0.05),而原发组与复发组肿瘤之间DNA拓扑异构酶Ⅱα的表达水平无统计学差异(P>0.05)。结论颅咽管瘤的病理亚型以及DNA拓扑异构酶Ⅱα的表达水平与肿瘤的预后和复发有关,可作为预测肿瘤复发危险性的一个参考指标;DNA拓扑异构酶Ⅱα的表达水平在原发组和复发组肿瘤之间无显著性差异,提示肿瘤在复发过程中瘤细胞的增殖活性无明显变化。

Objective To detect the expression status of DNA topoisomerase Ⅱα alpha （DNA TopoⅡα） in craniopharyngioma tissues, analyze the relationship between DNA TopoⅡα expression and tumor recurrence, and determine whether DNA TopoⅡα may be a valuable index in judging the prognosis of craniopharyngiomas. Methods The prospective cohort study program was designed. The expression level of DNA TopoⅡα was investigated by immunohistochemical avidin-biotin-peroxidase complex （ABC） method in 63 cases of tissue sections of craniopharyngioma. The quantitative analysis for DNA TopoⅡα expression was performed by using TE2000-U inverted biological microscopy and Image-Pro Plus professional image analysis software. The proliferative potential of oncocytes was evaluated in matched groups, such as adamantine epitheliomas （AE） and squamous papillary tumors （SP）, recurrence and recurrence-free groups, as well as primary and relapse groups. Results Fourteen of 32 cases of AE and 6 of 31 cases of SP recurred during follow-up period. There were significant differences on DNA TopoⅡα expression level both between AE and SP groups, and between recurrence and recurrence-free groups （ P 〈 0. 05, two-tailed ）, but there was not significant difference on DNA TopoⅡα expression level between primary and relapse groups （ P 〉 0. 05 ）. Conclusion The pathological subtypes of craniopharyngiomas and DNA TopoⅡα expression level are related with the prognosis of craniopharyngiomas. There was not significant difference in DNA TopoⅡα expression level between primary and relapse groups, which indicates that the proliferative activity of craniopharyngioma cells has not changed during recurring process.