复发性膀胱尿路上皮癌中IMP3和CD44蛋白表达

IMP3 and CD44 protein expression in recurrent bladder urothelial carcinoma

目的:评价IMP3和CD44蛋白在复发性膀胱癌中表达及二者的相关性。方法:收集2002年1月至2012年12月经尿道膀胱肿瘤电切术诊断为尿路上皮癌(UC)的病例,其中筛选出6个月内短期复发组25例和3年以上较长期首次复发组29例。应用半定量免疫组织化学法检测短期复发组和较长期首次复发组UC病例中IMP3和CD44蛋白表达情况。结果:6个月内UC复发为25例,6例表达IMP3,且均为高级别UC。3年以上较长期首次UC复发为29例,仅有1例低级别UC表达IMP3。在短期复发组中IMP3阳性率为24%(6/25),表达强度为弱阳性16%(4/25)和强阳性8%(2/25),明显高于较长期首次复发组中阳性率3.45%(1/29)以及表达强度中的弱阳性3.45%(1/29)和强阳性0(0/29)。CD44蛋白表达在两组之间差异无统计学意义。IMP3表达与UC复发患者的肿瘤分期、分级呈正相关,而CD44表达与肿瘤的分级呈负相关。IMP3表达与CD44表达之间无明显相关性。结论:IMP3在UC短期复发组中的表达明显高于较长期首次复发组。IMP3可作为新的指标,并联合肿瘤病理分期、分级等因素对膀胱UC患者经尿道肿瘤电切术后短期复发的高危性进行预测。

Objective： To evaluate the expression of IMP3 and CD44 proteins in recurrent urothelial carcinoma （UC） and to deter- mine the correlation between the two proteins. Methods： Data from transurethral resection of bladder （TURB） cancer cases between January 2002 and December 2012 were reviewed. Of the 54 UC recurrent cases in this study, one group of 25 had experienced recur- rence within 6 months after surgery, and the other group of 29 had their first recurrence afier more than 3 years. IMP3 and CD44 immu- noreactivities were increased, which correlated with the clinicopathologic parameters. The relationship between IMP3 and CD44 pro- tein expressions was also explored. Results： Six of the 25 short-term recurrent UC cases were tested positive for IMP3 and all belonged to high-grade UC. Among the 29 long-term recurrent patients, only one case of low-grade UC tested positive for IMP3. IMP3 expres- sion rate [24% （6/25）] and intensity [weak staining at 16% （4/25） and strong staining at 8% （2/25）] were higher in the short-term recur- rent group than those in the long-term group, which had an expression rate of 3.45% （1/29） and intensity rates for weak staining at 3.45% （1/29） and without strong staining （0/29）. No difference was observed in the CD44 expression between the two groups. In addi- tion, the high expression of IMP3 correlated with higher tumor stage and grade, whereas the CD44 expression tended to be inversely correlated with the tumor grade in recurrent UC patients. Furthermore, no correlation existed between the expression of IMP3 and CD44 proteins in the bladder carcinoma specimens. Conclusion： IMP3 exhibited a significantly higher expression rate in short-term re- current UC specimens than in the long-term recurrent cases. Therefore, IMP3 could be used as a novel marker, together with the other factors including tumor stage and grade, for predicting the high risk of short-term recurrence in UC patients who underwent TURB.