血型抗原Lewis A和Lewis X在膀胱移行细胞癌中的表达及其诊断价值

目的探讨血型抗原Lewis A和Lewis X在膀胱移行细胞癌中的表达及其诊断应用价值。方法病理标本取1981-2001年间复旦大学附属金山医院病理科的膀胱移行细胞癌标本,具有完整临床病理资料共83例及非肿瘤移行上皮标本68例。试剂选用Lewis A、Lewis X单克隆抗体,应用免疫组化Envision二步法进行染色。并收集10例膀胱移行细胞癌及10例正常人的尿脱落细胞标本进行Lewis X免疫染色。结果Lewis A和Lewis X在膀胱移行细胞癌中的表达阳性率分别为81.9%（68/83）和83.1%（69/83）,非肿瘤黏膜中的阳性表达率分别为52.9%（36/68）和11.8%（8/68）。Lewis A和Lewis X的表达强度与膀胱移行细胞癌的病理分级和临床分期无关（P〉0.05）,但膀胱移行细胞癌的Lewis A和Lewis X表达强度显著高于非肿瘤黏膜（P〈0.05）。20例尿脱落细胞标本中,8例膀胱移行细胞癌Lewis X表达阳性,10例正常对照全部阴性。结论Lewis X免疫标记应用到膀胱移行细胞癌的尿脱落细胞学诊断上,为膀胱移行细胞癌早期诊断及随访提供一种可能的方法。Lewis A抗原对膀胱移行细胞癌诊断价值低于Lewis X。

Expression of Lewis A and Lewis X in transitional cell carcinomas of urinary bladder and its value in diagnosis

Objective To explore the expression of Lewis A and Lewis X in transitional cell carcinoma of the urinary bladder(TCC)and its value in pathological diagnosis.Methods Eighty-three cases of TCC specimens and 68 cases of non-neoplastic bladder mucosa were selected.Monoclonal antibodies against antigen Lewis A and X were stained by Envision's two-step immunohistochemical method.Lewis X of urine deciduous cell specimens in 10 cases of TCC and 10 cases of normal controls were detected by immune staining.Results Positive rates of Lewis A and Lewis X in TCC specimens were 81.9% and 83.1%,respectively,while in non-TCC bladder mucosas the positive rates were 52.9% and 11.8%,respectively.The expression of Lewis A and Lewis X was not correlated to the grade and stage of transitional cell carcinoma(P>0.05).The expression of Lewis A and Lewis X in TCC was significant higher in noncancerous mucosa(P<0.05).In 20 cases of urine deciduous cell specimens,Lewis X was positive in 8 cases of TCC,but negative in control group.Conclusion Lewis A and Lewis X may be valuable diagnostic markers of TCC,especially Lewis X,which is helpful for the detection of low grade of TCC.