基膜蛋白在腺样囊性癌中表达的免疫组化研究

Immunohistochemical Study of Basement Membrane Proteins Expression in Adenoid Cystic Carcinoma of Salivary Glands

目的 :研究基膜蛋白在涎腺腺样囊性癌 (ACC)中的表达特征 ,并探讨其与 ACC细胞分化程度及预后的关系。方法 :选取经病理证实为 ACC的 10 1例病例 ,进行临床病理资料分析及随访。然后选取其中 3 0例进行基膜蛋白的免疫组织化学标记。结果 :1ACC实体型及含有该成分的混合型 ACC患者预后较差 ,发生转移或 (和 )复发的比例较高 ,且 ACC局部复发比远处转移更为多见。 2 ACC基膜的存在部位及阳性表达程度与其类型有关 ,阳性程度以筛状型表达最高 ,管状型次之 ,实体型最差。此外 ,筛状型 ACC中 ,有转移或 (和 )复发的病例阳性表达低。 3 4种基膜蛋白中 ,纤维粘连蛋白在各类型 ACC中的表达均较差。结论 :1基膜蛋白的阳性表达程度与 ACC的恶性程度呈负相关。基膜蛋白可作为评估患者预后的依据之一。 2在参与组成基膜的物质中 ,基膜粘连蛋白可能是肿瘤实质细胞与基膜胶原粘附的主要物质。

Objective: To investigate the expression of the basement membrane proteins in adenoid cystic carcinoma (ACC) of the salivary glands and discuss the relationship between the expression of the proteins and the differentiation as well the prognosis of ACC. Methods: 101 patients which were confirmed pathologically were collected and made a follow up, and 30 cases of them were selected to detect the basement membrane proteins (type Ⅳ collagen, fibronectin, laminin and heparan sulfate proteoglycan) by the means of immunohistochemistry. Results: The cribriform pattern of ACC had a more favorable prognosis than the solid pattern which had a lower rates of metastasis of/and recurrence. The positive locations and the degrees of the four proteins varied with the histological patterns of ACC. The cribriform pattern had the strongest positive expression and the solid pattern the weakest. In addition, the staining of fibronectin were weaker in all three patterns of ACC. Conclusion: The degree of the positive expression of the four proteins has a negative relation to the differentiation of the tumor cells. The lower degree of differentiation the tumor cells are, the weaker positive signals they express. Of the four substances in the basement membrane, laminin is the main material which adhere the parenchymal cell to the collagen in basement membrane of the tumor. Basement membrane proteins could be regarded as one of the basis to evaluate the prognosis of ACC.