层粘连蛋白在上皮性卵巢肿瘤中的表达及其与预后的相关性

Expressions of laminin in epithelial ovarian tumors and its correlation with prognosis

目的研究层粘连蛋白(LN)在卵巢上皮性肿瘤中的表达情况及其与卵巢癌临床特征和预后的相关性。方法选取2001年1月至2006年12月在哈尔滨医科大学附属第一医院治疗的正常卵巢20例、良性卵巢肿瘤30例、交界性卵巢肿瘤30例、恶性卵巢肿瘤60例,采用免疫组织化学方法检测组织中LN的表达情况。结果在正常卵巢、良性、交界性与恶性4组之间,LN的表达阳性程度比较,差异有统计学意义(Hc=24.127,P<0.01);基底膜表达的完整性分级比较,差异亦有统计学意义(Hc=53.263,P<0.01)。LN在癌巢基底膜表达的完整性与临床分期、组织分化程度、淋巴结转移、腹水形成及术后生存时间有关:临床分期晚、组织学分化差、淋巴结转移、腹水形成及术后生存时间短的肿瘤,比临床分期早、组织学分化好、无淋巴结转移、无腹水及术后生存时间长的肿瘤LN表达明显减少甚至缺失(P均<0.01);而恶性肿瘤不同组织学分型间LN的表达无统计学差异(P>0.05)。结论 LN作为细胞黏附相关因子与恶性肿瘤的浸润和转移有关,癌巢周围层粘连蛋白的缺失可作为判断肿瘤恶性程度和预后的指标,可望成为判断卵巢癌预后的独立性因素。

Objective To study the expressions of laminin （LN） in epithelial ovarian tumors and its correlation with clinieopathologieal features and prognosis of patients with ovarian cancer. Methods A total of 140 samples of ovarian tissues by excision from the First Affliated Hospital of Harbin Medical University between January 2001 and December 2006 were en- rolled in this study,which including 20 cases of normal ovarian tissues,30 cases of benign ovarian tissues ,30 cases of border- line ovarian tissues and 60 cases of ovarian epithelial cancer tissues. The expressions of LN on ovarian tissues were detected by immunohistochemistry SP method. Results There was significant difference in positive degrees of LN expressions among nor- mal ovarian tissues ,benign ovarian tissues ,borderline ovarian tissues and ovarian epithelial cancer tissues （Hc = 24. 127, P 〈 O. O1 ）. There also was significant difference in integrity grading of basement membrane expression among the 4 groups （ Hc = 53. 263 ,P 〈0. O1 ）. The integrity of LN expression on basement membrane of cancer nests was associated with clinical stages, organization＇s differentiation degree,lymphatic metastasis, ascites formation and postoperative survival time. Compared with the tumors of early clinical stage, high differentiation degree, no metastasis of lymphatic node, no ascites and longer postoperative survival time, the expressions of LN obviously weakened even lacked in the tumors of late-stage, low differentiation degree, hav- ing metastasis of lymphatic node, having ascites and shorter postoperative survival time （ all P 〈 O. O1 ）. The expressions of LN had no statistical significance in different histologic type of malignant tumors （ P 〉 0. 05 ）. Conclusions As a cell adhesion-re- lated factor, LN is related to invasion and metastasis of the malignant tumor. The lack of LN around cancer nests can be servedas an index of judging the malignant degree and prognosis of tumors. LN is expected to become an independent factor for judging prognosis of ovarian cancer.