CCT2和Galectin-3在胰腺良恶性病变中的表达及其临床意义

Expressions of CCT2 and Galectin-3 and its clinical significances in benign and malignant lesions of pancreas

目的检测CCT2、Galectin-3在胰腺导管腺癌、癌旁组织、良性病变及正常胰腺组织中表达,探讨其临床病理学意义。方法收集106例胰腺导管腺癌、35例匹配的距癌组织≥2 cm处癌旁组织、55例胰腺良性病变(慢性胰腺炎20例、腺瘤20例、上皮内瘤变15例)、13例正常胰腺组织标本。记录胰腺导管腺癌患者的性别、年龄及肿瘤最大径、分化程度、TNM分期、有无淋巴结转移、有无周围组织浸润。采用EnVision免疫组织化学法检测CCT2和Galectin-3的表达。采用单因素及多因素分析法分析影响患者术后生存期的危险因素。结果106例胰腺导管腺癌组织CCT2、Galectin-3阳性表达率分别为54.7%和50.9%,35例癌旁组织阳性表达率分别为25.7%和28.6%,55例胰腺良性病变组织阳性表达率分别为23.6%和20.0%,13例正常胰腺组织均阴性表达。胰腺导管腺癌组织CCT2、Galectin-3阳性表达率显著高于癌旁组织、良性病变及正常胰腺组织,差异均有统计学意义(P值均<0.05)。淋巴结转移及TNMⅢ+Ⅳ期的胰腺导管腺癌患者的CCT2、Galactin-3阳性表达率显著高于无淋巴结转移及TNMⅠ+Ⅱ期患者,有周围组织器官浸润的胰腺导管腺癌CCT2阳性表达率显著高于未浸润周围组织器官者,低分化腺癌Galactin-3阳性表达率显著高于高分化者,差异均有统计学意义(P值均<0.05);而患者年龄、性别及肿瘤最大径与CCT2、Galectin-3阳性表达无明显相关性。106例胰腺导管腺癌患者的生存期为2~24个月,平均(9.4± 0.7)个月,术后1、2年生存率分别为27.3%(29例)、2.8%(3例)。肿瘤分化程度低、肿瘤直径大、TNM分期晚、有淋巴结转移及周围组织浸润、CCT2及Galactin-3阳性患者的平均生存期均显著短于分化程度高、肿瘤直径小、TNM分期早、无淋巴结转移及周围组织浸润、CCT2及Galactin-3阴性患者,差异均有统计学意义(P值均<0.05)。Cox多因素分析结果显示,肿瘤分化程度低、肿瘤最大径≥5 cm、TNM Ⅲ或Ⅳ期、有淋巴结转移及周围组织器官浸润、CCT2和Galectin-3表达阳性为影响患者预后的独立危险因素。结论胰腺导管腺癌组织CCT2和Galectin-3高表达,与肿瘤的生物学行为和预后相关。

Objective To investigate the expressions of CCT2 and Galectin-3 in pancreatic ductal adenocarcinoma,para-carcinoma tissues,benign lesions and normal tissues and to assess their clinicopathological significances.Methods 106 cases of pancreatic ductal adenocarcinoma,35 cases of matched para-carcinoma tissues ≥2 cm away from cancerous tissues,55 cases of pancreatic benign lesions (20 cases of chronic pancreatitis,20 cases of adenoma,15 cases of intraepithelial neoplasia),and 13 cases of normal tissues were collected.The gender,age,maximal tumor diameter,differentiation,TNM stage,the presence of lymph node metastasis and surrounding tissue infiltration of the patients with pancreatic ductal adenocarcinoma were recorded.EnVision immunohistochemistry was used to detect the expression of CCT2 and Galectin-3.Univariate and multivariate anlysis were applied to analyze the factors influencing the postoperative survival of the patients.Results The positive rates of CCT2 and Galectin-3 in 106 cases of pancreatic ductal adenocarcinoma were 54.7% and 50.9%,which was 25.7% and 28.6% in 35 cases of para-carcinoma tissues,23.6% and 20.0% in 55 cases of pancreatic benign lesions,and negative expression in 13 cases of normal tissues.CCT2 and Galectin-3 positivity rate in pancreatic ductal adenocarcinoma was significantly higher than para-carcinoma tissues,pancreatic benign lesions and normal tissues,and the differences were statistically significant (P<0.05).Positivity rate of CCT2 and Galectin 3 expression in the patients with TNM stage Ⅲ-Ⅳ and lymph node metastasis was significantly higher than that in patients with TNM stageⅠ-Ⅱ and no lymph node metastasis;the positivity rate of CCT2 expression in pancreatic ductal adenocarcinoma with surrounding organ infiltrated was obviously higher than that without surrounding organ infiltrated;the positivity rate of Galectin 3 expression in poorly differentiated adenocarcinoma was obviously higher than that in well differentiated adenocarcinoma;and all the differences were statistically significant (all P<0.05).The expression of CCT2 and Galectin-3 had no obvious correlation with the patients' gender ,age and maximal tumor diameter.The survival period of 106 cases of pancreatic ductal adenocarcinoma was 2-24 months with the average of 9.4±0.7 months.The 1-year and 2-year postoperative survival rate after surgery was 27.3%(n=29)and 2.8%(n=3).The survival period of patients with poorly differentiated degree,larger maximal tumor diameter,advanced TNM stage,the presence of lymph node metastasis and surrounding tissue invasion,and positive expression of CCT2 and Galectin 3 was shorter than that of patients with well differentiated degree,smaller maximal tumor diameter,early TNM stage,the absence of lymph node metastasis and surrounding tissue invasion,and negative expression of CCT2 and Galectin 3,and the difference was statistically significant (P<0.05).Cox multivariate analysis showed that poorly differentiated degree,maximal tumor diameter ≥5 cm,TNM stage Ⅲ-Ⅳ,the presence of surrounding invasion and lymph node metastasis,and positive expression of CCT2 and Galectin 3 were independent risk factors for influencing patients' prognosis.Conclusions CCT2 and Galectin 3 were highly expressed in pancreatic ductal carcinoma,which was associated with the biological behaviors and prognosis of the tumor.