上皮性卵巢癌组织中黏着斑激酶的表达及临床意义

Expression of Focal Adhesion Kinase in Epithelial Ovarian Cancer and Its Clinical Significance

目的探讨黏着斑激酶(focal adhesion kinase,FAK)在人类上皮性卵巢癌(epithelial ovarian cancer,EOC)中的表达及与临床病理特征间的关系。方法选择2004年6月至2007年12月本院收治的术前未接受放、化疗,经手术切除的56例上皮性卵巢癌患者标本为研究对象(研究组)。将研究组按淋巴结转移情况分为,有淋巴结转移组[盆腔及腹主动脉旁淋巴结转移(合并肝实质转移)+大网膜、阑尾转移,n=37],无淋巴结转移组(n=19);按患者年龄分为年龄<50岁组(n=27)和年龄≥50岁组(n=29);按2000年国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)对恶性肿瘤的分期标准,分为T1,T2期组(n=15),T3,T4期组(n=41);按照恶性肿瘤病理学分级原则分为Ⅰ级组(n=16),Ⅱ级组(n=25)和Ⅲ级组(n=15);按照不同组织学类型分为浆液性组(n=30),黏液性组(n=16)和内膜样癌组(n=10)。选取同期在本院诊断为卵巢良性肿瘤的22例(浆液性乳头状囊腺瘤为14例,黏液性乳头状囊腺瘤为8例)患者标本纳入对照组(本研究遵循程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批准,分组征得患者本人的知情同意,并与其签署临床研究知情同意书)。两组患者年龄比较,差异无显著意义(P>0.05)。采用χ2检验比较研究组和对照组标本的黏着斑激酶阳性表达率。采用Western免疫印迹(Western-blot)技术检测研究组中是否有淋巴结转移组、不同临床分期组、不同病理学分级组、不同年龄组上皮性卵巢癌标本黏着斑激酶阳性表达率,并进行组间比较。采用χ2检验及Fisher精确概率检验分析其表达水平与临床病理特征间的相关性。结果黏着斑激酶阳性表达率研究组为76.9%(43/56),对照组为9.1%(2/22),二者比较,差异有显著意义(P<0.05)。研究组不同临床分期肿瘤组织黏着斑激酶阳性表达率比较,差异有显著意义(P<0.05)。研究组标本中,有淋巴结转移组黏着斑激酶阳性表达率与无淋巴结转移组比较,差异有显著意义(P<0.05);不同年龄组、不同病理学分级和不同组织学类型上皮性卵巢癌组织中,黏着斑激酶阳性表达率比较,差异无显著意义(P>0.05)。结论黏着斑激酶在上皮性卵巢癌组织中表达明显高于良性肿瘤组织。在上皮性卵巢癌组织中,黏着斑激酶阳性表达率,与有无淋巴结转移、临床分期密切相关,与患者年龄、上皮性卵巢癌病理学分级及组织学类型无关。

Objective To investigate the relationship between the expression of focal adhesion kinase （FAK） in human epithelial ovarian cancer （EOC） and clinicopathological features. Methods From June 2004 to December 2007, western-blot was used to detect the expression of focal adhesion kinase in 56 epithelial ovarian cancer with different clinical stages and different degrees of differentiation （research group）. Research group was furthermore divided into following sub-groups： Lymph node metastasis sub group （n= 37）, and non-lymph node metastasis sub group （n=19）; 〈50-year old group （n=27） and ≥50 year old group （n=29）; T1, T2 sub-group （n= 15） and T3, T4 sub-group （n=41） according to the clinical staging of malignant tumors made by International Federation of Gynecology and Obstetrics （FIGO） in 2000; grade Ⅰ sub-group （n= 16）, grade Ⅱ sub-group （n=25）, and grade Ⅲ sub-group （n= 15） according to the principle of pathological classification of malignant tumors; serous sub-group （n = 30）, mucinous sub group （n=16）, and endometrloid carcinoma sub group （n=10） by different histological tyDes. Another 22 cases with ovarian benign tumors were included to control group, including 14 cases with serous papillary cystadenoma and 8 cases with mucinous papillary cystadenoma. Informed consent was obtained from all participants. The positive expression rate of focal adhesion kinase between research group and control group was compared. The relationship between expression levels of focal adhesion kinase and clinieopathological characteristics were analyzed by x^2 test and Fisher exact test. Results The positive rate of focal adhesion kinase in research group was 76.9% （43/56） and in control group was 9. 1 % （2/22） （P〈 0.05）. Significant difference was found in the positive expression rate of focal adhension kinase with different clinical staging （P〈0.05）. There was significant difference of different clinical stages between node metastasis sub-group and non metastasis sub group （P〈0.05）. There were no significant differences in the expression of focal adhesion kinase with different age of patients, pathologic grades and histologic types of tumors （P〉0.05）. Conclusion The expression level of focal adhesion kinase in ovarian cancer is higher than that of benign tumors. The positive expression rate of focal adhesion kinase has a close relationship with clinical staging and lymph node metastasis of epithelial ovarian cancer, but it has no relationship with age, pathological grades and histological types of tumors.