趋化因子受体6在膀胱尿路上皮癌中的表达及其临床意义

Expression and Clinical Significance of the C-X-C Chemokine Receptor 6 in Urothelial Carcinoma of the Bladder

目的观察趋化因子受体6(CXCR6)在膀胱尿路上皮癌和正常膀胱粘膜组织中的表达情况,并分析其与肿瘤临床生物学行为以及复发和进展的关系。为进一步深入研究CXCR6影响膀胱尿路上皮癌生物学行为的机制提供线索。方法选择89例初诊为膀胱尿路上皮癌标本,30例正常膀胱粘膜组织标本:肿瘤标本中非肌层浸润性膀胱尿路上皮癌64例,肌层浸润性癌25例;低级别(LG)32例,高级别(HG)57例;单发肿瘤48例,多发41例;非肌层浸润性膀胱尿路上皮癌中,随访期间出现术后首次复发38例,未复发26例;术后首次进展22例,未进展42例。采用ElivisonTM免疫组织化学方法,检测CXCR6蛋白在膀胱尿路上皮癌和正常膀胱粘膜组织中的表达。并结合患者的临床资料进行分析。结果正常组织中CXCR6蛋白的阳性表达率为20%(6/30),肿瘤组织中为75.3%(67/89);LG和HG组织中CXCR6蛋白表达阳性率分别为69%(44/64)、92%(23/25),非肌层浸润性和肌层浸润性肿瘤组织中CXCR6蛋白表达阳性率分别为69%(44/64)、92%(23/25),组间比较差异均有统计学意义(P<0.05)。非肌层浸润性膀胱尿路上皮癌组织术后复发和未复发组CXCR6蛋白的表达阳性率分别为84.2%(32/38)、46.2%(12/26);术后进展和未进展组蛋白的表达阳性率分别为91%(20/22)、57.1%(24/42)。组间差异均有统计学意义(P<0.05)。Kaplan-Meier曲线和Log-Rank检验显示,CXCR6蛋白表达阳性组和阴性组患者的术后复发生存率和无进展生存率的差异均有统计学意义(P<0.05)。结论 CXCR6蛋白的表达与膀胱尿路上皮癌组织的恶性程度和浸润深度相关,并且可能影响患者的预后,提示CXCR6可能参与了膀胱尿路上皮癌的发生和进展。

Objective To detect the expression of the C-X-C chemokine receptor 6 in urothelial carcinoma of the bladder and analyze the relationship with theClinicopathological factors of the patients. Methods Immunohistochemical staining was per-formed in 89 cases of bladder cancer tissues and 30 normal bladder tissue,including 20 peritumor tissues and 10 tissues which was resected from the radical cystectomy,partial cystectomy and the normal bladder neck tissues resected from TURP. Kaplan-Merier univariate survival analysis and Log-Rank test was performed to evaluate the prognosis value of non-muscle invasive bladder cancer patients. Results Among the 89 cases of bladder cancer tissues,67（67/89） cases showed positively staining of CXCR6,6（6/30） cases showed positively staining of CXCR6 and CXCL16 in normal bladder tissues,respectively. The expression level of CXCR6 was positively correlated with the pathological grade,T stage（P〈0. 05）. Those who showed positive staining of CXCR6 are prone to recurrent and progress shorter than the control group. Conclusion The C-X-C chemokine receptor 6 is higher than in urothelial carcinoma of the bladder and the analysis of CXCR6 protein expression is potentially valuable in prognostic marker of bladder canc-ers. CXCR6 may play a vital role in the carcinogenesis and the progression of urothelial carcinoma of the bladder.