肿瘤干细胞标记物ALDH1在非浸润性膀胱癌组织中的表达及其临床意义

Expression of tumor stem cells marker ALDH1 in noninvasive bladder cancer tissue and its clinical significance

目的:探讨肿瘤干细胞标记物乙醛脱氢酶1(ALDH1)在非浸润性膀胱癌组织中的表达,初步了解肿瘤干细胞与膀胱癌生物学特征的关系。方法:采用免疫组织化学法检测118例非浸润性膀胱癌组织及30例癌旁正常膀胱组织中ALDH1的表达,并结合临床病理及预后资料进行关联性分析。结果:在非浸润性膀胱癌组织中ALDH1阳性表达率为24.58%,在癌旁正常膀胱组织中为6.67%,2组比较差异有统计学意义(P<0.05);在低级别和高级别非浸润性膀胱癌组织中ALDH1阳性表达率分别为18.18%(14/77)和36.59%(15/41),二者比较差异有统计学意义(P<0.05);在pTa期和pT1期非浸润性膀胱癌组织中ALDH1阳性表达率分别为16.92%(11/65)和33.96%(18/53),二者比较差异有统计学意义(P<0.05);在初发和复发的非浸润性膀胱癌组织中ALDH1阳性表达率分别为19.77%(17/86)和37.50%(12/32),差异有统计学意义(P<0.05);ALDH1表达与非浸润性膀胱癌患者性别、年龄及肿瘤大小无明显关联性(P>0.05)。术后随访4～52个月,ALDH1阳性表达组和阴性表达组无瘤生存率分别为55.17%和61.80%,Kaplan-Merier曲线及Log-rank检验,2组患者累积无瘤生存时间比较差异有统计学意义(P<0.05)。结论:ALDH1表达与膀胱癌病理分级、分期及肿瘤复发有关联。肿瘤干细胞可能在非浸润性膀胱癌的发生和复发中具有重要作用。

Objective To explore the expression of tumor stem cells marker aldehyde dehydrogenase 1（ALDH1） in noninvasive bladder cancer tissue and to investigate the relationship between tumor stem cells and the biological characters of bladder cancer.Methods The expressions of ALDH1 in 118 cases of noninvasive carcinoma specimens and 30 cases of normal bladder tissue surrounding cancer were detected by immunohistochemistry and analyzed by combining with clinical pathology and prognosis data.Results The positive expression rates of ALDH1 were 24.58% and 6.67% in specimens of cancer and normal bladder specimens,respectively,and the difference between them was statistically significant（P0.05）.The positive expression rate of ALDH1 in high-grade group（36.59%,15/41） was higher than that in low-grade group（18.18%,14/77）（P0.05）.The positive expression rate of ALDH1 in pT1 stage（33.96%,18/53） was higher than that in pTa stage（16.92%,11/65）（P0.05）.The positive expression rate of ALDH1 in recurrent group（37.50%,12/32） was higher than that in primary tumor group（19.77%,17/86）（P0.05）.The ALDH1 expression was not related to gender,age and tumor size of patients with noninvasive bladder cancer（P0.05）.During a 4-52 months follow-up period,the tumor-free survival rates in ALDH1-positive group and ALDH1-negative group were 55.17% and 61.80%,respectively.Kaplan-Meier analysis and Log-rank test showed that the differences of cumulative tumor-free survival rate was statistically significant between ALDH1-positive group and ALDH1-negative group（P0.05）.Conclusion The ALDH1 expression is related to the pathological grades,stages and recurrence of bladder cancer.The tumor stem cells may play a role in the tumorigenesis and recurrence of noninvasive bladder cancer.