CD117、MITF及NAT10在鼻腔鼻窦黏膜黑色素瘤中的表达及预后意义

Expression of CD117,MITF and NAT10 and their prognostic values in sinonasal mucosal melanoma

目的 探讨CD117、MITF及NAT10在鼻腔鼻窦黏膜黑色素瘤( SNMM)中的表达及其与患者临床病理特征的关系.方法 选取1999年12月至2013年11月复旦大学附属眼耳鼻喉科医院治疗的80例SNMM患者的石蜡标本.采用罗氏自动免疫组织化学染色仪检测CD117、MITF及NAT10在SNMM组织中的表达情况,分析其表达水平与患者临床病理特征及预后的关系.结果 男性40例,女性40例.年龄26~85岁,中位年龄61岁. CD117、MITF及NAT10的表达与患者年龄、性别、发生部位、临床分期、治疗方式、脑转移均无相关性(均P>0. 05);MITF及NAT10的表达与肿瘤淋巴结转移有关,MITF及NAT10高表达时肿瘤更易转移(均P<0. 05),而CD117的表达与淋巴结转移未见明显相关性.分析CD117的表达与患者生存预后的相关性,Log-rank检验结果提示CD117的表达与3年、5年生存率相关(P=0. 012;P=0. 023),CD117低表达时患者预后较差. COX分析显示CD117低表达、患者高龄、脑转移是SNMM预后的独立危险因素(均P<0. 05). MITF与NAT10的表达水平与SNMM患者的预后均无相关性(P>0. 05). CD117、MITF及NAT10的表达与SNMM的无病生存期均未见明显相关性( P>0. 05).结论 CD117 低表达时患者生存率较低, MITF 高表达和NAT10高表达时 SNMM 容易转移,CD117 的表达可以作为评估 SNMM 预后的重要指标,MITF 和NAT10的表达可以作为预测肿瘤转移的参考指标.

Objective To investigate the correlation between the expression of CD117,MITF, NAT10 and clinical parameters in sinonasal mucosal melanoma (SNMM).Methods Formalin-fixed paraffin-embedded tumor specimens of 80 cases of SNMM at the Eye,Ear,Nose and Throat Hospital,Fudan University,from December 1999 to November 2013 were analyzed for CD117,MITF and NAT10 expression by immunohistochemistry.Results There were 40 men and 40 women.The median age was 61 years,age 26 to 85years.There was no correlation of the expression of CD117,MITF and NAT10 with the patients' age,gender,tumor site,stage,therapy method and brain metastases (P>0.05).The expression of MITF and NAT10 was associated with lymph node metastasis and the tumors were more likely to metastasize when MITF and NAT10 were positive.However,expression of CD117had no correlation with lymph node metastasis.Log-rank test revealed that the expression of CD117was correlated with both three-year and five survival rate (P=0.012,P =0.023;respectively)and patients with tumor having low expression of CD117 had the worse outcome.COX test revealed that low CD117 expression,advanced age and lymph node metastasis were independent risk factors (P <0.05).No significant association was found between the expression of CD117,MITF and NAT10 with disease free survival (P>0.05).Conclusions Patients with SNMM expressing low level of CD117 have decreased survival rate.Tumors with high level of MITF and NAT10 expression are more likely to metastasize.The expression level of CD117can be used as an important indicator for the patient survival,and the expression of MITF and NAT10 can be used as a predictor of tumor metastasis.