细胞黏附、多药耐药及细胞增殖在T_1G_3型浅表膀胱癌近期复发中的作用

The role of cell adhesion, multidrug resistance and cell proliferation in short-term recurrent cases with T_1G_3 superficial bladder cancer

目的 研究细胞黏附、多药耐药及细胞增殖在浅表膀胱癌近期复发中的作用 ,探讨三者的临床预测价值。 方法 对 10 0例浅表膀胱癌患者进行回顾性随访 ,同时用免疫组化法检测首次术后标本中E cad、P gp、Ki 6 7的表达情况。 结果 E cad、P gp的阳性表达率分别为 4 3 2 %和14 4 % ,而PI的平均值为 2 2 1%。E cad表达随复发次数增加而减弱 (P <0 0 5 ) ,P gp表达和PI值随复发次数增加而增高 (P <0 0 5 )。T1G3 型患者与非T1G3 型患者间 ,E cad表达、P gp表达及PI值差异均有显著性 (P <0 0 5 )。E cad表达与P gp表达、PI值之间均呈显著性负相关。 结论 黏附性低、耐药性强和增殖旺盛是促使T1G3 型浅表膀胱癌近期复发的主要因素 ,同时也是导致T1G3 肿瘤易复发、高恶性度的内在原因。在上述过程中 ,三者可能相互影响。

Objective To evaluate the roles of cell adhesion,multidrug resistance and cell proliferation in short-term recurrent cases with superficial bladder cancer, and the prognostic value of the three indexes. Methods Immunohistochemical staining for E-cad,P-gp and Ki-67 was performed on the tumors of 100 patients with stage T0-T1 transitional cellcarcinoma of the bladder who had been included in a retrospective research by follow-up. Results E-cad and P-gp expression was positive in 51(43.2%)and 17(14.4%) of the tumors,respectively and mean proliferation index(PI)was 22.1%. The decrease in E-cad expression was accompanied with the increasing recurrent episodes(P<0.05),while increase of P-gp expression and PI were accompanied with the increasing recurrence episodes(P<0.05).There was significant difference according to E-cad,P-gp positivity and between T 1G 3 patients and no-T 1G 3 patients (P<0.05).There was negative correlation of E-cad expression with P-gp expression and PI. Conclusions Minimum adhesion, strong drug resistance and maximum proliferation are the main factors that promote short-term recurrence of superficial bladder cancer and also the inherent reasons for easy recurrence and high malignancy of T 1G 3 tumors. During this course, the three aspects may interact.