错配修复基因hMLH1，hMSH2在肝门部胆管癌中的表达和意义

Expression of hMLH1 and hMSH2 in hilar cholangiocarcinoma and its significance

目的检测肝门部胆管癌中错配修复基因hMLH1，hMSH2失表达情况，研究其与肝门部胆管癌临床特征的关系，并探讨其与预后的相关性。方法用免疫组织化学技术检测54例肝门部胆管癌组织、25例正常胆管中hMLH1，hMSH2表达，结合临床病理学资料及随访统计资料进行统计学处理分析。结果（1）在54例肝门部胆管癌组织中，hMLH1蛋白阳性表达24例，其阳性率44．4％；25例正常胆管组织中，hMLH1蛋白阳性表达23例，其阳性率92．0％；hMSH2蛋白癌组织阳性表达21例，其阳性率38．9％；hMSH2蛋白在正常胆管组织阳性表达21例，其阳性率84．0％。hMLH1，hMSH2在肝门部胆管癌组织中的表达明显减少，二者比较差异具有统计学意义（P〈0.05）。（2）根据统计学检验，hMLH1，hMsH2表达与肝门部胆管癌Bismuth分型（P〉0．05）、病人性别（P〉0．05）、年龄（P〉0．05）、肿瘤大小（P〉0．05）无关，但与病理分级（P〈0．05）和淋巴结转移（P〈0.05）具有显著相关性。（3）hMLH1表达阴性组术后2年生存率明显低于表达阳性组（15％VS45．4％，P〈0.05）。hMSH2表达阴性组术后2年生存率明显低于表达阳性组（23．5％VS44％，P〈0.05）。结论hMLH1，hMSH2在肝门胆管癌中的失表达在肿瘤的发生、发展及转移中起重要作用，是判断预后有价值的指标。

Objective To investigate the expression of hMLH1 and hMSH2 in hilar cholangiocarcinoma and its relation to clinical features and prognosis of the tumor. Methods The expression of hMLH1 and hMSH2 was determined with immunohistochemistry in 54 specimens of hilar cholangio- carcinoma and 25 of normal bile duct tissue. Laboratory data were then analyzed statistically together with the related clinicopathological data. ResuIts 1） hMLH1 and hMSH2 were expressed in 24 and 21 out of the 54 cases of hilar cholangiocarcinoma （44.4%, 38.9%） and 23 and 21 of the 25 normal cases （92%, 84%）, respectively （P〈0. 05）. 2） The expression of hMLH1 and hMSH2 in hilar cholangiocarcinoma had no association with the age, gender, tumor size and Bismuth type （P^-0.05） but close relation to lymph node metastasis and pathological changes （P〈0.05）. 3） The 2-year survival rate was markedly lower in hMLHl-negative patients than in hMLH1- and hMSH2-positive ones （15%0 vs. 45.4%, 23.5% vs. 44%0, P〈0.05）. Conclusions Joint action of hMLH1 and hMSH2 plays an important role in the oncogenesis and metastasis of hilar cholangiocarcinoma. These two may be valuble factors to indicate prognosis of the tumor.