原发性肾上腺皮质肿瘤组织中间隙连接蛋白32和43的表达及其临床意义

Expression and clinical significance of Cx32 and Cx43 in primary adrenal cortical tumors

目的研究间隙连接蛋白(Cx)32和43在原发性肾上腺皮质肿瘤中的表达,探讨其在原发性肾上腺皮质肿瘤的临床诊断及预后评估中的价值。方法应用免疫组化NovolinkTMPolymer法检测21份正常肾上腺组织、45份肾上腺皮质腺瘤及14份肾上腺皮质癌标本中Cx32、Cx43的表达水平,运用SPSS13.0统计软件进行统计学处理。结果 Cx32和Cx43在肾上腺皮质癌中表达阳性率分别为21.4%和35.7%,明显低于肾上腺皮质腺瘤中的68.9%和75.6%(P=0.002,P=0.010)及正常肾上腺组织中的85.7%和100%(P=0.000,P=0.000);肾上腺皮质腺瘤中Cx43表达的阳性率低于正常肾上腺组(P=0.013)。Cx43的表达与肾上腺皮质腺癌患者的预后相关(P<0.05),Cx43表达越低患者预后越差。在肾上腺皮质癌中,Cx32和Cx43之间的表达呈明显正相关(P=0.015)。结论联合检测Cx32和Cx43的表达对鉴别良、恶性肾上腺皮质肿瘤具有重要的参考意义。Cx43在原发性肾上腺皮质癌组织的表达与患者预后相关,增加其表达可能改善患者预后。

Objective To explore the expression and clinical significance of connexin 32 and connexin 43 proteins in adrenal tumors. Methods The expression of connexin 32 and connexin 43 in 80 specimens including 21 cases of normal adrenal gland,45 ca- ses of cortex adenoma and 14 cases of cortex adenocarcinoma,were detected by NovolinkTMpolymer immunohistochemistry. Results The positive rate of connexin 32 and connexin 43 were 21.4 %, 35.7 % in cortex adenocarcinoma which were significantly lower than 68.9% and 75.6% respectively in cortex adenoma（P=0. 002,P=0. 010） and it also lower than 85.7% and 100% respective- ly in normal adrenal gland（P=0. 000,P=0. 000）. The positive rate of connexin 43 was 75.6% in cortex adenoma which was signif- icantly lower than 100% in normal adrenal gland（P=0. 013）. The positive expression of connexin 43 was negative correlated with the prognosis of adrenal cortex adenocarcinoma：the lower expression intensity of connexin43, the worse the patients prognosis（P〈0.05）. Incortex adenocarcinoma,the expression of connexin 32 was positive correlated with the expression of connexin 43. Conclu- sion Measurements of connexin 43 and connexin 32 may helpful to distinguish malignant from non-malignant tumors. Expression of connexin 43 is closely correlated to the prognosis of patients,increasing the expression of connexin 43 may improve the patients prognosis.