胰腺癌术前24h吉西他滨化疗的临床意义及Syk的表达

Clinical significance of gemcitabine hydrochloride-based chemotherapy 24 h before pancreatic cancer surgery and the expression of Syk

目的:探讨胰腺癌术前24 h应用吉西他滨化疗的临床意义,观察胰腺癌组织Syk的表达及其组织病理学变化。方法:应用HE染色和免疫组化法,观察实验组(术前24 h应用吉西他滨化疗)及对照组(未行化疗)正常胰腺组织及其癌组织细胞形态学改变、Syk的表达,探讨Syk与p53关系。结果:HE染色,实验组可见胰腺肿瘤细胞坏死明显,细胞空泡变性增多,核固缩、凝固性坏死显著,肿瘤组织及其周围组织中可见大量淋巴细胞和嗜酸性细胞浸润。免疫组化法,对照组胰腺癌组织中Syk表达较低,染色浅,颗粒不明显,正常胰腺组织中Syk呈强阳性表达,颗粒明显;实验组胰腺癌细胞Syk的表达明显增强,染色深,颗粒粗,Syk染色接近正常胰腺组织表达。实验组正常胰腺组织、癌组织中Syk表达的阳性率分别为92．3%、69．2%。对照组正常胰腺组织、癌组织中Syk表达的阳性率分别为86．2%、54．5%;两组胰腺癌组织之间的Syk阳性表达率差异有显著统计学意义(P＜0．01)。实验组、对照组p53蛋白阳性表达率分别为79．3%、59．9%,与Syk阳性表达一致率分别为89%、84%,Syk的表达与p53表达呈正相关。实验组患者生存时间明显延长,与对照组相比有显著意义(P＜0．01)。结论:胰腺癌术前24 h应用吉西他滨化疗患者中位生存期延长,免疫组化可见Syk的阳性表达率上升。

Objective： To study the clinical significance of gemcitabine hydrochloride-based chemotherapy at 24 h prior to pancreatic cancer operation and observe the expression of Syk and the changes of clinicopathological features. Methods： The patients were divided into two groups. One group received gemcitabine hydrochloride chemotherapy （experimental group） and the other group did not （control group）. The HE staining and the immunohistochemical methods were used to evaluate the morpho- logical changes and the expression of Syk and p53 in normal pancreatic tissues and pancreatic cancerous tissues of experimental group and control group. The relationship between the expression of Syk and p53 were analyzed. Results： Pancreatic cancer patients in experimental group showed apparent necrosis of tumor cells characterized by increased vacuolation and significant pyknosis and coagulative necrosis. The inflammation of lymphocytes and eosinophils around the tumor tissues were severe. Syk had lower expression, light staining, and little granules in pancreatic cancerous tissues of control group. In experimental group the expression of Syk was increased with stronger immunohistochemical staining and rough granules. The degree of Syk positive staining was near the normal pancreatic tissues. The positive rate of Syk expression in normal and pancreatic cancer tissues of experimental group was 92.3 % and 69.2 %, respectively. It was 86.2 % and 54.5 % in normal and pancreatic cancer tissues of control group, respectively. The difference between the two groups was significant （P〈0.01）. The rate of positive expression of p53 protein in pancreatic cancer tissue of experiment group and control group was 79.3% （9/13） and 59.9% （13/22）, respectively. The expression of Syk and p53 protein had positive correlation. Conclusion： Gemcitabine hydrochloride-based chemotherapy at 24 h prior to operation for pancreatic cancer increases the positive rate of Syk expression and prolonged the median survival time of patients in clinic.