胆囊癌淋巴转移和预后与CC族趋化因子受体7表达的关系

Clinical analysis of the expression of CC chemokine receptor 7 and its relationship with lymphatic metastasis and prognosis in gallbladder cancer

目的探讨CC族趋化因子受体7(CCR7)在胆囊癌组织的表达及其与胆囊癌淋巴转移和预后的关系.方法免疫组织化学染色(IHC)检测CCR7表达水平,结果以平均吸光度值(IA)表示;Kaplan-meier法进行生存分析、COX回归分析独立预后因素.结果47例胆囊癌组织CCR7 IA值(0.329±0.116)显著高于20例癌旁正常组织CCR7 IA值(0.165±0.107,P<0.01).TNM0-Ⅱ期组CCR7 IA值(0.306±0.116)显著低于Ⅲ~Ⅳ期组IA值(0.423±0.102,P<0.01);淋巴结转移阳性组CCR7 IA值(0.424±0.103)显著高于淋巴结转移阴性组(0.356±0.123,P<0.05).年龄<60岁组(0.363±0.114)较≥60岁组(0.414±0.116)、男性(0.406±0.118)较女性(0.381±0.116)、肿瘤<5 cm组(0.384±0.125)较≥5 cm组(0.402±0.107)、腺癌组(0.402±0.116)与其他类型组(0.337±0.112)的CCR7 IA值差异均无统计学意义(均P>0.05);组织学分级低(0.404±0.108)、中(0.419±0.109)、高(0.328±0.126)分化组CCR7 IA值差异亦无统计学意义(P>0.05).CCR7高表达组中位生存时间4.75个月,明显低于CCR7低表达组(22个月,P<0.01).单因素分析显示肿瘤大小、淋巴结转移、TNM分期和CCR7表达水平与胆囊癌预后有关(P<0.05).多因素分析结果显示淋巴结转移、TNM分期和CCR7表达水平是影响胆囊癌预后的独立危险因素(P<0.05).结论CCR7在胆囊癌组织呈高表达,其表达强度与TNM分期和淋巴结转移呈正相关,与生存时间呈负相关.

Objective To investigate the expression of CC chemokine receptor 7(CCR7)in gallbladder cancer(GBC)and its relationship with lymphatic metastasis and prognosis of GBC.Methods Immunohistochemical staining(IHC)was used to detect the expression of CCR7.Mean optical density(IA)was used to assess the staining intensity of IHC.Kaplan-meier method was used for survival analysis and COX regression analysis was used to determine independent prognostic factors.Results The IA value of CCR7 in 47 patients with GBC was(0.329±0.116),significantly higher than that in 20 patients with paracancer normal gallbladder(0.165±0.107,P<0.01).The IA value of CCR7 of TNM0-D group(0.306±0.116)was significantly lower than that of JU-IV group(0.423±0.102,P<0.01).The IA value of CCR7 in the lymph node-positive group(0.424±0.103)was significantly higher than that in the lymph node-negative group(0.356±0.123,P<0.05).There was no significant difference in IA values of CCR7 between the<60-year old group(0.363±0.114)and the<60-year old group(0.414±0.116),the male group(0.406±0.118)and the female group(0.381±0.116),the tumor size<5 cm group(0.384±0.125)and the M5 cm group(0.402±0.107),the adenocarcinoma group(0.402±0.116)and the other type group(0.337±0.112),the poor histological grade group(0.404±0.108)/moderate group(0.419±0.109)and the high group(0.328±0.126)(P>0.05).The median survival time of the CCR7 higher expression group was 4.75 months,significantly lower than that of the CCR7 lower expression group(22 months,PvO.01).Univariate analysis showed that tumor size,lymph node metastasis,TNM staging and CCR7 expression were associated with the prognosis of GBC(P<0.05).Multivariate analysis showed that lymph node metastasis,TNM staging and CCR7 expression were independent risk factors for the prognosis of GBC(P V 0.05).Conclusion CCR7 is highly expressed in GBC tissues,and its expression intensity is positively correlated with TNM stage and lymph node metastasis,and negatively correlated with survival time.CCR7 can be used as a predictor of lymphatic metastasis and poor prognosis of GBC.