联合表达人端粒酶反转录酶hTERT及VEGF与肿瘤复发的关系

Expression of VEGF Combined with hTERT gene in the BTCC and recurrence of bladder cancer

目的应用肿瘤发生、发展不同阶段的联合瘤标对膀胱移行细胞癌(BTCC)检测,比较其肿瘤复发诊断的特异性。方法对67例BTCC和作为对照的10例正常膀胱上皮石蜡标本分别用免疫组化法和原位杂交法,检测其血管内皮生长因子(VEGF)和人端粒酶反转录酶(hTERT)的表达。结果两者在正常膀胱上皮中不表达,在BTCC中均不同程度表达,67例BTCC组织中,hTERT强阳性表达28例,其中有肿瘤复发的18例(64.3%),VEGF表达为强阳性共51例,其中有肿瘤复发的30例(58.8%),联合瘤标均强阳性例数为21,有肿瘤复发的18例(85.7%),其特异性与单一瘤标均有显著差异(P<0.05)。结论把针对肿瘤生物学行为不同阶段的瘤标联合,能有效提高诊断的准确度,有希望作为预测BTCC预后复发的有效手段。

Objective To investgate the value of combined determination of tumor markers for bladder transitional cell carcinoma （BTCC） that reflect different stages of fumor development and progress, comparing their diagnostic specificity for tumor recurrence. Methods By in situ hybridization and S- P immunohistochemical method, we assayed the expression of vascular endothelial growth facfor（VEGF） hTERT gene protein in paraffin - embedded BTCC tissues of 67 cases and in normal bladder tissues of 10 cases. Their clinical significance was analysed by chi - sguare test. Results Strong positive expressions of hTERT gene and VEGF were detected in 28 and 30 BTCC tissues, respectively, while there was no such expression in nomal bladder tissues. The specificities of the markers for diagnosing BTCC recurrence were 64.3 % （18/28） for hTERT and 58.8 % （30/51 ） for VEGF; the specificity of combined determination was 85.7 % （ 18/21 ）, significantly different from that of hTERT or VEGF alone（ P 〈 0.05）. Conclusions The combined determination of hTERT and VEGF which reflect the different stages of tumor development and progress has higher diagnostic accuracy; it may be an effective means for predicting the recurrence of BTCC.