胆囊良恶性病变组织中蛋白基因产物9.5的表达及临床意义

Expression of protein gene product 9.5(PGP9.5) and clinical significances in the benign and malignant lesions of gallbladder

目的研究胆囊腺癌、癌旁组织、慢性胆囊炎组织中蛋白基因产物9.5(PGP9.5)表达及其临床病理意义。方法108例胆囊腺癌、46例癌旁组织和35例慢性胆囊炎切除标本常规石蜡包埋切片,PGP9.5染色方法为EnVisionTM免疫组化法。结果胆囊腺癌PGP9.5表达阳性率(45.4%)和评分(1.94±1.84)明显高于癌旁组织(17.4%,!2=10.83,P<0.01;0.86±1.41,t=3.60,P<0.01)和慢性胆囊炎组织(11.4%,!2=13.06,P<0.01;0.58±1.29,t=4.08,P<0.01);PGP9.5阳性良性病变胆囊上皮均呈中至重度不典型增生。患者年龄≤45岁、腺瘤癌变或高分化腺癌、肿块最大径<2cm、无淋巴结转移和未侵犯周围组织病例PGP9.5表达阳性率及其评分明显低于年龄>45岁、低分化腺癌、肿块最大径≥2cm、淋巴结转移和侵犯周围组织病例(P<0.05或P<0.01)。结论PGP9.5表达可能是反映胆囊腺癌发生、进展和预后的重要生物学标志物,检测胆囊良性病例PGP9.5表达水平对于预防和早期发现胆囊癌可能有重要临床意义。

Objective To study the expression of PGP9.5 and its clinicopathological significances in tissues of gallbladder adenocarcinoma, pericancerous tissues and chronic cholecystitis. Methods Immunohistochemical method was used for the detection of PGP9.5 expressive levels in routinely paraffin-embedded sections from the specimens of gallbladder adenocarcinoma （n=108）, pericancerous tissues （n=46） and chronic cholecystitis （n=35）. Results The positive rates and scores of PGP9.5 in gallbladder adenoeaercinoma （45.4%, 1.94±1.84） were significantly higher than those in pericancerous tissues （17.4%, Х^2=10.83, P〈0.01; 0.86±1.41, t=3.60, P〈0.01） and chronic cholecysitis （11.4%, Х^2=13.06, P〈0.01; 0.58±1.29, t=4.08, P〈0.01）. The positive rates and scores of PGP9.5 were significantly lower in the cases of aged ≤45 years, adenomatous canceration or high-differentiatied adenocarcinoma, maximal diameter of mass 〈2 cm, no-metastasis of lymphnode, and noinvasion of regional tissues than those in the ones of aged 〉45 years, low-differentiated adenocarcinoma, maximal diameter of mass ≥2 cm, metastasis of lymphnode and invasion of regional tissues. Conclusion The expressive levels of PGP9.5 may be an important marker for reflecting the carcinogenesis, progression, biological behaviors and prognosis of gallbladder adenocarcinoma. The assayes of PGP9.5 expressive levels in benign lesions of gallbladder may have important clinical values for the prevention and early-stage finding of gallbladder carcinoma.