T-cad在表浅性膀胱移行细胞癌中的表达与临床意义

The level and clinical significance of T-cad protein in superficial bladder carcinoma

目的比较尿液及组织中T-cad蛋白在表浅性膀胱移行细胞癌患者的水平,探讨其在表浅性膀胱癌诊断与随访中的临床应用价值。方法选择50例初发表浅性膀胱移行细胞癌和50例其他泌尿系统疾病患者,检测术前晨尿液中T-cad蛋白的水平。50例浅表性膀胱癌患者均行经尿道膀胱肿瘤电切术,病理标本检测T-cad蛋白的表达;术后予规律灌注化疗及膀胱镜检随访。比较其表达水平与肿瘤G分级及复发的关系。结果表浅性膀胱癌组尿液T-cad蛋白平均浓度为(2.12±1.16)ng/ml;与对照组[(3.03±1.97)ng/ml]比较差异无统计学意义(P=0.08)。17例G1患者中5例(29.4%)膀胱癌组织中T-cad蛋白的低表达或无表达;33例G2-G3患者中17例(51.5%)出现膀胱癌组织中T-cad蛋白的低表达或无表达;T-cad在G1的表达高于G2-G3,差异有统计学意义(P<0.05)。T-cad高表达的28例膀胱癌患者中5例复发,复发率17.9%;T-cad低表达的22例膀胱癌患者中12例复发,复发率54.5%。两者间差异有统计学意义(P<0.05)。结论膀胱癌组织中T-cad蛋白表达与G分级、肿瘤复发负相关;膀胱癌组织中T-cad蛋白的低表达可能与膀胱癌的发生进展相关。

Objective To compare the expression of T-cad protein in superficial bladder carcinoma and study the evaluation in diagnosis and follow-up. Methods Urine were collected from 50 cases with superficial bladder transitional cell carcinoma (TCC) and other 50 controls. T-cad protein levels in the urine of these cases were measured. The 50 superficial bladder TCC cases were received regular bladder perfusion chemotherapy and cystoscopy examination after transurethral resection of bladder tumor. T-cad expression levels in the tissues were examined by immunohistochemical staining, and their correlation with clinicopathologic parameters (e.g. G grade and recrudescence) were analyzed. Results The average urine T-cad concentration was (2.12±1.16) ng/ml in bladder TCC group, and was (3.03±1.97) ng/ml in the control group. There was no significant difference between them (P=0.08). Five cases (29.4%) had low or no expression of T-cad protein in the tissue of 17 patients with G1 superficial bladder TCC. Seventeen cases (51.5%) had low or no expression of T-cad protein in the tissue of 33 patients with G2-G3 superficial bladder TCC. The expression of T-cad in G1 was higher than that in G2-G3, and the difference was significant (P < 0.05). Recurrence rate was 17.9% in 28 bladder cancer patients with high T-cad expression, and was 54.5% in 22 bladder cancer patients with low T-cad expression. There was a significant difference between the two groups (P < 0.05). Conclusions Decreased T-cad expression in the tissue of bladder TCC was negatively correlated with high grade and tumor relapse, and may be associated with malignancy of bladder TCC.