谷氨酸脱氢酶在肝外胆管癌患者肿瘤组织中的表达及其临床意义

目的 探讨肝外胆管癌(ECC)患者肿瘤组织中谷氨酸脱氢酶(GLDH)的表达水平及其临床意义。方法 选取2005年1月～2015年12月于榆林市第一医院肝胆外科手术切除的160例ECC患者组织标本作为病例组,另选同期胆管正常组织标本30例作为对照组。采用免疫组织化学染色法检测GLDH表达情况,统计分析ECC患者肿瘤组织GLDH表达水平与临床病例特征及预后的相关性。结果 病例组GLDH低表达、中表达和高表达分别占28.1%(45/160),35.6%(57/160)和36.2%(58/160); 对照组为73.3%(22/30),23.3%(7/30)和3.3%(1/30),两组比较差异具有统计学意义(χ²=24.590,P=0.000)。ECC患者肿瘤组织GLDH表达与患者年龄、CD34表达情况、细胞分化程度及有无神经浸润均密切相关(χ²=12.145～158.075,均P<0.05)。GLDH低表达、中表达、高表达ECC患者平均生存时间分别为44.3个月、26.0个月和11.6个月,3组生存曲线差异有统计学意义(χ²=18.367,P=0.001)。Cox多因素分析结果显示肿瘤组织GLDH高表达是ECC患者预后不良的独立危险因素(HR=3.873,95%CI 1.515～9.903,P=0.005)。结论 GLDH可能成为ECC患者预后的评价指标。

Expression and Clinical Significance of Glutamate Dehydrogenase in Tumor Tissues of Patients with Extrahepatic Cholangiocarcinoma

Objective To investigate the expression and clinical significance of glutamate dehydrogenase(GLDH)in tumor tissues in patients with extrahepatic cholangiocarcinoma(ECC).Methods A total of 160 cases of ECC resections collected from January 2005 to December 2015were recruited to participate in the study as the case group.Meanwhile,30 samples of normal bile duct tissue were taken as the control.The expression of GLDH in 160 cases of ECC and 30cases of normal bile duct tissue were detected by immunohistochemistry(IHC).Statistical analysis was used to analyze the correlation between GLDH and clinicopathological features and prognosis.Results Low,moderate and high expression rate of GLDH in case group were28.1%(45/160),35.6%(57/160)and 36.2%(58/160),respectively,and in control group,they were 73.3%(22/30),23.3%(7/30)and 3.3%(1/30),respectively.The difference was statistically significant.GLDH expression level was correlated to patient age,CD34 expression,cellular differentiation and neural invasion in ECC tissues(χ²=12.145～158.075,all P<0.05).Mean survivaltime of low,moderate and high GLDH expression in case group were 44.3 months,26.0 months and 11.6 months,respectively.Log-rank test showed highly significant differences in overall survival between different GLDH expression(χ²=18.367,P=0.001).Cox multivariate analysis showed that high GLDH expression was independently associated with ECC poor prognosis(HR=3.873,95%CI:1.515～9.903,P=0.001).Cox multivariate analysis showed that high GLDH expression was independently associated with ECC poor prognosis(HR=3.873,95%CI:1.515～9.903,005).Conclusion GLDH may be an important prognostic indicator of ECC.