Ezrin蛋白、CD44、E-钙粘素与神经母细胞瘤转移的关系

The expressions of Ezrin protein, CD44 and E-cadherin in neuroblastoma

目的探讨Ezrin蛋白、CD44、E-钙粘素在神经母细胞瘤中的表达及其与神经母细胞瘤转移的关系。方法应用免疫组织化学二步法检测40例神经母细胞瘤标本中Ezrin蛋白、CD44、E-钙粘素的表达情况，并应用统计学方法比较其在局灶期、进展期的病例、FH型（组织结构良好型）和UFH型（组织结构不良型）及不同年龄性别病例中的表达程度。结果Ezrin蛋白在进展期患儿中的表达为20例，明显高于局灶期病例的15例，且有统计学意义（H=6．124，P=0．013）。而在进展期病例中CD44的表达为6例，明显低于局灶期的12例，E-钙粘素的表达5例则明显低于局灶期的11例，并且均有统计学意义（H=4．950，P=0．026；H=5．455，P=0．020）。Ezrin蛋白和CD44在FH型和UFH型表达的差异具有统计学意义（H=5．182，P=0．023；H=4．496，P=0．034）。而E-钙粘素在FH中表达为阳性的有11例。在UFH型中为5例，经统计学检验两者之间差异无明显统计学意义（H=2．754，P=0．097）。Ezrin蛋白在不同年龄组中的差异具有统计学意义，而CD44和E-钙粘素没有，三者在不同性别组中的表达无明显统计学差异。经统计学分析Ezrin蛋白的表达与CD44的表达呈负相关（X^2=4．675，P=0．031，r=-0．323）。Ezrin蛋白的表达与B钙粘素蛋白的表达呈负相关（X^2=6．077，P=0．014，r=-0．123）。E-钙粘素蛋白的表达与CD44的表达呈正相关（X^2=6．077，P=0．014，r=-0．363）。结论Ezrin蛋白、CD44和E-钙粘素的表达与NB的转移有关，其中Ezrin蛋白可促进肿瘤的转移，而CD44、E-钙粘素则对肿瘤的转移有抑制作用。年龄是影响Ezrin蛋白表达的因素之一，但不影响CD44和E-钙粘素的表达，而性别对Ezrin蛋白、CD44和E-钙粘素的表达没有影响。在NB的发生、发展过程中Ezrin蛋白与CD44之间，Ezrin蛋白与E-钙粘素之间可能存在负协同效应，而CD44与E-钙粘素之间可能存在正协同效应。

Objective To study Ezrin protein, CD4 and E-cadherin expressions and their association to metastasis of neuroblastoma（NB）. Methods The expressions of Ezrin Protein, CD44 and Ecadherin in 40 NB patients were detected by two-step immunohistochemistry staining, and the expression levels of these proteins were analyzed according to local stage and advanced stage, favor able histology （FH） and the unfavorable histology （UFH）, age and gender. Results Strong expression of Ezrin Protein was detected on- ly in 15 patients in local stage tumors, and in 20 advanced stage tumors （compared local stage tumors, H = 6. 124,P=0. 013）. Strong CD44 staining was found in 12 in local stage tumors, and in 6 advanced stage tunaors （H= 4. 950,P= 0. 026）. Strong E-cadherin staining was found in11 local stage tufters, and in 5 advanced stage tumors （H= 5. 455 ,P = 0. 020）. The difference between Ezrin Protein expression in the type of FH and UFH type was significant （H = 5. 182,P= 0. 023）, and so did the CD44 （H = 4. 496,P = 0. 034）. The expression of Ezrin protein was related to the age. There was negative correlation between the expression of Ezrin and the CD44 （X^2 = 4. 675, P = 0. 031, r= - 0. 323）, and the expression of Ezrin and the E- cadherin （X^2 = 6. 077, P = 0. 014, r = -0. 123）. While positive correlation between the CD44 and E-cadherin （X^2 =6. 077, P=0. 014, r= -0.363） was noted. Conclusions Ezrin Protein, CI344 and E-cadherin expressions may be related to metastasis and progression of NB. While Ezrin protein can stimulate tumor metastasis, CD44 and E-cadherin may have an inhibitory effect. Age is one of factors influence the expression of Ezrin protein in neuroblastoma.