肌肉浸润性膀胱癌中腺苷酸激酶4的表达及临床意义

Expression of AK4 in Muscle Infiltrating Bladder Cancer and Its Clinical Significance

目的探讨腺苷酸激酶4(AK4)在肌肉浸润性膀胱癌组织中的表达及其临床意义。方法回顾性分析2006年3月至2012年11月天津市第一中心医院接受膀胱癌根治手术治疗的85例肌肉浸润性膀胱癌患者的临床资料。采用免疫组织化学法检测85例膀胱癌组织和对应的癌旁组织中AK4的表达,分析其与临床病理学特征的关系。结果 AK4的阳性表达主要在细胞质内,呈棕黄色颗粒。AK4在膀胱癌组织中均有一定的阳性表达,而在癌旁组织中无表达。AK4的阳性高表达率为70.6%(60/85)。膀胱癌远处转移的AK4高表达率高于无远处转移者,有脉管内瘤栓的AK4高表达率高于无脉管内瘤栓者(P<0.05),不同性别、年龄、肿瘤分期和分级、淋巴结转移和复发的AK4高表达率比较差异无统计学意义(P>0.05)。生存分析提示,在膀胱癌中AK4高表达的患者生存时间明显短于低表达患者(P<0.05)。结论肌肉浸润性膀胱癌组织中存在AK4表达水平上调,并与膀胱癌远处转移和脉管内瘤栓有关,且AK4异常表达可能提示膀胱癌患者预后不良。

Objective To explore the expression of adenylate kinase 4(AK4)in muscle infiltration bladder transi-tional cell carcinoma and its clinical significance.Methods The clinical data of 85 patients with muscle infiltration bladder transitional cell carcinoma who underwent radical surgery at Tianjin First Center Hospital from Mar.2006 to Nov.2012 was analyzed.The immunohistochemistry method was used to detect the expression of AK4 in the cancer tissues and para-carcinoma tissues of the 85 patients,and the relationship between AK4 and clinical pathological characteristics was analyzed.Results The positive expression of AK4 was mainly in the cytoplasm,presenting as brownish yellow granules.The AK4 showed a certain positive expression in bladder cancer tissues and was not expressed in the adjacent tissues.The high positive rate of AK4 expression in bladder cancer tissues was 70.6%(60/85).The high positive rate of AK4 expression was significantly correlated with the distant metastases and the vascular tumor embolus(P<0.05),but was not significantly associated with the gender,age,tumor staging and grading,lymph node metastasis or recurrence(All P>0.05).Survival analysis suggested that the survival time of patients with AK4 high expression in bladder cancer was significantly shorter than those with low expression(P<0.05).Conclusion Up-regulation of AK4 expression exists in muscle infiltration bladder cancer tissues,and it is associated with the distant metastases and the vascular tumor thrombus,which might suggest poor prognosis for the patients with bladder cancer.