十二指肠乳头癌中埃兹蛋白和钙黏蛋白的表达与预后关系研究

Relationship among Expressions of Ezrin,E-cadherin Protein and Surviving Prognosis in Duodenal Papilla Neoplasm

目的探讨埃兹蛋白(Ezrin)、钙黏蛋白(E-cadherin)的表达与十二指肠乳头癌的临床预后关系。方法收集十二指肠乳头腺瘤28例患者和腺癌46例患者的组织标本,应用免疫组化方法对Ezrin、E-cadherin在十二指肠乳头腺瘤和腺癌组织中的表达水平进行测定。结果在十二指肠乳头癌组织中Ezrin、E-cadherin的表达阳性率分别为73.91%(34/46)和21.74%(10/46),腺瘤组织中分别为46.23%(13/28)和85.71%(24/28),两种组织中Ezrin、E-cadherin表达阳性率差异均有统计学意义(P<0.05),Ezrin和E-cadherin在十二指肠乳头癌组织中表达呈负相关且与肿瘤分化程度、临床分期及淋巴结转移显著相关(P<0.05)。单因素分析发现,两种蛋白的表达、肿瘤分化程度、临床分期、淋巴结转移与术后生存密切相关。多因素分析发现,两种蛋白的表达、肿瘤分化程度、淋巴结转移是影响预后的独立因素。结论 Ezrin和E-cadherin对十二指肠乳头癌的发生、发展及预后起重要作用,可能成为十二指肠乳头癌的分子标记物或治疗的潜在靶点。

Objective To detect the expressions of Ezrin and E - cadherin in duodenal papilla neoplasm tissues and to evaluate the relationship between the expressions and clinical prognosis. Methods Immunohistochemical method （ S - P method） was used to detect the expressions of Ezrin and E - cadherin in 28 cases of duodenal papilla neoplasm and 46 cases of adenocarci- noma tissues. Results The positive rates of Ezrin and E - cadherin iri duodenal papilla neoplasm tissues were 73.91% （34/46） and 21.74% （10/46） respectively, and 46. 23% （ 13/28 ） and 85.71% （24/28） in adenocarcinoma tissues respectively, the difference was statistically significant （ P 〈 0. 05 ） . The expressions of Ezrin and E - cadherin in duodenal papilla neoplasm tissues were negatively correlated, and were significantly related to histological classification, clinical stages and lymph metastasis （ P 〈 0.05 ） . Univariate analysis showed that the expressions of Ezrin and E - cadherin, carcinoma differentiation level, clinical stages and lymph metastasis were significantly related to the survival after operation （ P 〈 0. 05 ） . Multivariate analysis showed that the expressions of Ezrin and E - cadherin, carcinoma differentiation level and lymph metastasis were independent prognostic factors. Conclusion Ezrin and E - cadherin might play a key role in the occurrence, development and prognosis of duodenal pa- pilla neoplasm, and they might become a molecular marker or potential molecular target for duodenal papilla neoplasm.