鸟氨酸脱羧酶和谷氨酸脱羧酶65在鼻腔鼻窦良恶性病变中的表达及意义

Expression and Chinicopathological Significance of Ornithine Decarboxylase and Glutamate Decarboxylase 65 in Benign and Malignant Lesions of Rhinosinus

目的研究鼻腔鼻窦腺癌、癌旁组织、鼻内翻性乳头状瘤和慢性鼻窦炎鼻息肉中鸟氨酸脱羧酶(ODC)和谷氨酸脱羧酶65(GAD65)的表达水平及其临床病理意义。方法67例鼻腔鼻窦腺癌及癌旁组织、48例鼻内翻性乳头状瘤和35例慢性鼻窦炎鼻息肉常规制作石蜡包埋切片,ODC和GAD65染色方法为EnVision免疫组织化学法。结果鼻腔鼻窦腺癌ODC和GAD65表达阳性率(73.1%,61.2%)明显高于癌旁组织(28.4%,χ2=17.26,P<0.01;20.9%,χ2=13.28,P<0.01)、鼻内翻性乳头状瘤(20.8%,χ2=8.66,P<0.01;27.1%,χ2=5.10,P<0.05)和慢性鼻窦炎鼻息肉(11.4%,χ2=28.28,P<0.01;17.1%,χ2=14.98,P<0.01)。鼻腔鼻窦高分化腺癌,未侵犯鼻腔和鼻窦外周组织及淋巴结未转移病例(临床分型T2N0M0)ODC和GAD65表达阳性率明显低于鼻腔鼻窦中分化和低分化腺癌,侵犯鼻腔和鼻窦外周围组织及淋巴结有转移病例(临床分型T3N0M0、T4N1M0)(P<0.01)。结论ODC和GAD65酶活性改变可能是反映鼻腔鼻窦腺癌发生、进展、生物学行为及预后的重要酶学指标。

Objective To investigate the expressive levels of ODC and GAD65,and detect their clincopathological significances in the benign and malignant lesions of rhinosinus.Methods EnVision immunohistochemical method was used for determining expression levels of ODC and GAD65 in the routinely paraffin-embedded sections from specimens of adenocarcinoma of rhinosinus and peritumoral tissues （n=67）,sinonasal inverted papillomas （n=48）,and chronic sinusitis and nasal polyps （n=35）.Results The positive expression rates of ODC and GAD65 in.adenocarcinoma of rhinosinus （73. 1%,61.2%）were significantly higher than those in peritumoral tissues （28.4%,χ2=17.26,P〈0.01;20.9%,χ2=13.28,P〈0.01）、and chronic sinusitis and nasal polyps（20.8%,χ2=8.66,P〈0.01;27.1%,χ2=5.10,P〈0.05）, and chronic sinusitis and nasal polyps （11.4%,χ2=28.28,P〈0.01;17.1%,χ2=14.98,P〈0.01）.The postive rates of ODC and GAD65 in highly-differentiated adenocarcinoma, no-metastasis of lymphnode, no-infiltration of regional tissues or organs （T2NOM0） were significantly lower than those in low differentiated adenocarcinoma, metastasis of lymphnode, infiltration of regional tissues or organs （T3NOM0,T4N1M0） （P〈0. 01）. Conclusion Changes of enzymatic activity of ODC and GAD65 might be important biological markers for reflecting the carcinogenesis, progression, bological behaviors and prognosis of adenocarcinoma of rhinosinus.