胰腺癌MUC4的表达及其临床相关影响因素的分析

Relationship between expression of MUC4 in pancreatic cancer and clinical factors

目的:研究胰腺癌组织中MUC4的表达及其与临床相关因素间的关系。方法:采用免疫组织化学法检测53例胰腺导管腺癌和对应癌旁组织,以及9例慢性胰腺炎组织MUC4的表达,分析胰腺癌MUC4的表达与肿瘤分化、分期、病人生存时间等临床因素之间的关系。结果:53例胰腺癌组织中MUC4蛋白阳性表达43例(81.1%),对应癌旁组织中MUC4蛋白均为阴性表达,9例慢性胰腺炎中MUC4蛋白阳性表达2例(22.2%)。MUC4蛋白在胰腺癌组织中阳性表达率显著高于癌旁组织及慢性胰腺炎组织(P<0.05),MUC4蛋白在胰腺癌组织中阳性表达程度在病人不同的性别、年龄、肿瘤部位、肿瘤大小、淋巴结转移、分化程度及临床TNM分期之间无统计学差异(P>0.05)。单因素及多因素生存分析显示,淋巴结转移、临床TNM分期和MUC4的表达是胰腺癌预后相关的重要独立因素,MUC4的高表达组预后较差(P<0.05)。结论:MUC4可能是一个特异的胰腺癌肿瘤相关标志物,在胰腺癌中有较高的表达率,MUC4的检测有助于胰腺癌的诊断,并可作为鉴别胰腺癌和慢性胰腺炎的一个重要参考指标;同时MUC4的检测还有助于判断手术病人的预后。

Objective To analyze the relationship between the expression of MUC4 in pancreatic cancer and clinical factors. Methods The expression of MUC4 was detected in 53 cases with pancreatic cancer and the paired para- carcinoma tissues, 9 cases with chronic pancreatitis by immunohistochemical（IHC） method. The relationship between MUC4 expression and clinical characteristics, including tumor differentiation, tumor staging and survival time, was analyzed. Results IHC analysis showed positive expression of MUC4 in 43/53 （81.1%） cases with pancreatic cancer, and 2/9 （22.2%） in cases with chronic pancreatitis, and none in the paired para-carcinoma tissues. The positive rate of the MUC4 expression in pancreatic cancer was significantly higher than that in the paired para-carcinoma tissues and in chronic pancreatitis （P〈0.05）. No relationship was found between MUC4 expression and clinical factors such as gender, age, tumor location, tumor size, lymph node metastasis, tumor differentiation, tumor staging （P〉0.05）. Both univariate and multivariate analyses of survival showed that lymph node metastasis, tumor differentiation and MUC4 expression were independent prognostic factors of survival after surgery for pancreatic cancer. The higher expression of MUC4 had a poorer prognosis （P〈0.05）. Conclusions MUC4 might be a specific tumor marker of pancreatic cancer. Overexpression of MUC4 in pancreatic cancer may be a diagnostic marker of pancreatic cancer, and expression of MUC4 may be used as a parameter for differentiation to pancreatic carcinoma from chronic pancreatitis. It can also be considered as a prognostic factor after operation.