浅表性膀胱癌PD-ECGF mRNA表达的意义

The significance of platelet-derived endothelial cell growth factor mRNA expression in superficial bladder cancer

目的 探讨浅表性膀胱癌中血小板衍化内皮细胞生长因子 (PD ECGF)mRNA表达的意义。方法 用逆转录多聚酶链反应 (RT PCR)分析了 2 8例浅表性膀胱癌和 6例正常膀胱粘膜的PD ECGFmRNA表达 ,并分析了PD ECGFmRNA表达与浅表性膀胱癌的固有层浸润及复发之间的关系。结果 所有标本均见不同程度的PD ECGFmRNA表达 ,粘膜固有层浸润的pT1期膀胱癌的PD ECGFmRNA表达是正常膀胱粘膜的 3 1倍 (t=2 13,P <0 0 5 ) ,是乳头状非浸润性膀胱癌 (pTa期 )的 2 2倍 (t=2 6 6 ,P <0 0 5 ) ;G3 级膀胱癌中PD ECGFmRNA表达是正常膀胱粘膜的 3 3倍(t=2 4 4 ,P <0 0 5 ) ,是G1 2 级膀胱癌的 2 5倍 (t=3 36 ,P <0 0 1)。全部病例获得随访 ,平均随访18个月 ,共复发 11例 ,复发者膀胱癌的PD ECGFmRNA水平是未复发者的 3倍 (t=4 4 9,P <0 0 1) ,用PD ECGFmRNA水平预测本组膀胱癌复发的敏感性为 81 8% ,特异性为 82 4 %。结论 PD ECGFmRNA表达不仅与浅表性膀胱癌的分化程度有关 ,而且在膀胱癌的早期浸润中起着重要作用 ,测定PD ECGFmRNA表达对判断浅表性膀胱癌的分化程度、固有层浸润与复发有一定意义。

Objective To investigate the mRNA expression of platelet-derived endothelial cell growth factor (PD-ECGF) in superficial bladder cancer and its significance. Methods PD-ECGF mRNA expressions were determined by RT-PCR in 28 cases of superficial bladder cancers and 6 cases of normal bladder mucosa. The relation between PD-ECGF mRNA expression and tumor invasion to lamina propria or recurrence after transurethral resection was also analyzed. Results Some degree of PD-ECGF mRNA expression was present in all the samples.The PD-ECGF mRNA level was 3.1-fold higher in pT_1 tumors than in normal bladder mucosa ( t =2.13, P <0.05) and 2.2-fold higher in pT_1 tumors than in pT_a tumors ( t =2.66, P <0.05); G_3 tumors expressed 3.3-fold higher PD-ECGF mRNA than normal bladder mucosa ( t =2.44, P <0.05) and 2.5-fold higher than G_ 1-2 tumors ( t =3.36, P <0.01).Eleven cases recurred during the mean follow-up period of 18 months. Three -fold higher PD-ECGF mRNA expression was showed in cases who recurred after transurethral resection than that in cases who did not recur ( t =4.49, P <0.01).The specificity and sensitivity of predicting tumor recurrence were 82.4% and 81.8% respectively using 0.095 as a cutoff value of PD-ECGF mRNA level in this group of superficial bladder cancer. Conclusion PD-ECGF mRNA expression correlates with tumor dedifferentiation and plays an important role in the early invasion in superficial bladder cancer.To analyze the PD-ECGF mRNA level contributes to the evaluations of tumor differentiation and invasion to lamina propria as well as recurrence prediction in superficial bladder cancer.