磷酸化mTOR在胆囊癌中的表达及其临床意义

Expression of activated mTOR in gallbladder carcinoma tissue and its clinical significance

目的:探讨磷酸化雷帕霉素哺乳动物靶标(phosphorylate-mammalian target of rapamycin,p-mTOR)在人胆囊癌组织中的表达及其临床意义。方法:应用组织芯片技术和免疫组织化学(EnVision)方法检测来自上海市浦东新区人民医院外科和第二军医大学长征医院肿瘤科2004-2007年间6例慢性胆囊炎、7例癌旁组织和59例胆囊癌组织中p-mTOR的表达,并分析其与胆囊癌浸润深度、分化、Nevin分期等病理特征之间的相关性。结果:p-mTOR在慢性胆囊炎组织、癌旁组织和癌组织中表达的阳性率分别为0、0和47.5%,表达差异有统计学意义(P<0.01)。p-mTOR在分化高、中和低/未分化的胆囊癌组织中阳性表达率分别为21.4%、48.1%和66.7%(P<0.01);在浸润至黏膜层/肌层、浆膜层和周围组织的胆囊癌组织中, p-mTOR的阳性表达率分别为30.0%、35.7%和71.4%(P<0.01);p-mTOR在Ⅰ/Ⅱ期、Ⅲ/Ⅳ期和Ⅴ期胆囊癌组织中的阳性表达率分别为11.1%、46.4%和66.7%,呈明显上升趋势(P<0.01)。结论:p-mTOR的表达与人胆囊癌的浸润深度、组织分化和Nevin分期密切相关,p-mTOR可能参与人胆囊癌的发生发展过程。

Objective：To investigate the expression of phosphorylate-mammalian target of rapamycin, p-mTOR, in human gallbladder carcinoma and its clinical significance. Methods： Six chronic cholecystitis tissues, 7 adjacent gallbladder carcinoma tissues and 59 gallbladder carcinoma tissues, obtained from Department of General Surgery, People＇s Hospital of Pudong New Area and Department of Oncology of Changzheng Hospital from 2004 to 2007, were evaluated by immunohistochemistry and tissue microarray for p-mTOR expression. The correlations among p-roTOR expression with gallbladder carcinoma invasion, differentiation and Nevin stage were analyzed. Results： The positive rates of p-mTOR in chronic cholevstitis, adjacent-neoplatic gallbladder carcinoma and gallbladder carcinoma tissue were 0, 0 and 47.5% , respectively （ P 〈 0.01 ）. The positive rates of p-roTOR in with well-, moderately- and poorly-differentiated gallbladder carcinoma tissues were 21.4%, 48.1% and 66.7%, respectively; there were a significant differences among the three groups（P 〈 0.01 ）. The positive rates in gallbladder carcinoma tissue with mucosa and muscle invasion, serous membrane invasion and peripheral tissue invasion were 30% , 35.7 % and 71.40% , respectively （ P 〈 0.01 ）. The positive rates in Ⅰ/Ⅱ,Ⅲ/Ⅳ and Ⅴ stage gallbladder carcinoma tissues were 11.1%, 46.4% and 66.7%, respectively, showing a significant increasing trend（ P 〈0.01 ）. Conclusion： The expression of p-mTOR is closely related with low differentiation, invasion and clinical stage （ Nevin stage） of gallbladder carcinoma and may participate in the development and progression of gallbladder carcinoma.