胰腺癌组织中硫酸软骨素蛋白多糖4的表达及其临床意义

Prognostic significance of chondroitin sulfate proteoglycan 4 over-expression in pancreatic cancer patients

目的探讨硫酸软骨素蛋白多糖4（chondroitin sulfate proteoglycan 4,CSPG4）在胰腺癌（pancreatic carcinoma）中的表达及其临床意义。方法收集2007年6月至2010年6月西南医院肝胆外科的胰腺导管腺癌及正常胰腺组织（距肿瘤边缘〉2 cm）标本各160例,其中男性124例,女性36例;年龄33-75（56.98±10.75）岁。应用免疫组织化学染色法检测其中CSPG4的表达,分析CSPG4的表达与临床病理参数的相关性;采用Kaplan-Meier法分析胰腺癌中CSPG4的表达与患者预后的关系,Cox回归模型分析胰腺癌患者预后的影响因素。结果胰腺导管腺癌组织中CSPG4的阳性表达率显著高于正常胰腺组织（46.25%vs 10.00%,P〈0.01）。胰腺癌中CSPG4的表达与有无淋巴结转移或血管侵犯、肿瘤T分期、TNM分期显著相关（P〈0.01）。胰腺癌中CSPG4阳性表达患者术后总生存率显著低于阴性表达者（P〈0.01）。CSPG4的表达是影响胰腺癌患者预后的独立危险因素之一（P〈0.01）。结论 CSPG4在胰腺导管腺癌中异常高表达,其表达水平是评估患者预后的独立预测指标,提示CSPG4可能成为胰腺癌治疗的一个新靶点。

Objective To investigate the expression and clinical significance of chondroitin sulfate proteoglycan 4（ CSPG4） in pancreatic cancer. Methods The expression of CSPG4 was detected by immunohistochemical staining in 160 pancreatic ductal adenocarcinoma（ PDAC） samples and 160 adjacent normal samples. The correlation between CSPG4 expression and clinicopathologic features of patients with pancreatic cancer was analyzed. Kaplan-Meier method was used to evaluate the impact of CSPG4 expression on postoperative survival of the patients with pancreatic cancer. Cox univariate and multivariate prognostic analysis was utilized to explore the prognostic factors of the patients with pancreatic cancer. Results The positive rate of CSPG4 expression was significantly higher in PDAC samples than in adjacent normal samples（ 46. 25% vs 10. 00%,P〈0. 01）. Remarkable correlations were found between the CSPG4 expression and the lymph node metastasis,vessel invasion,T staging as well as TNM staging（ all P〈0. 01）. The overall survival of CSPG4-positive patients was much lower than that of CSPG4-negative patients（ P〈0. 01）. The CSPG4 expression was one of independent risk factors which could significantly affect the prognosis of patients with pancreatic cancer（ P〈0. 01）. Conclusion CSPG4 is over-expressed in PDAC,and is an independent predictor to assess the prognosis of patients with pancreatic cancer.