胆囊腺癌中nm23和KAI1的表达及其临床意义

目的 探讨肿瘤转移抑制基因nm23和KAI1在胆囊腺癌中的表达及其临床意义.方法 收集31例胆囊腺癌患者的病理石蜡标本和临床病理资料,将标本连续切片进行免疫组化染色,检测nm23、KAI1的表达.所有患者随访3年.结果 31例患者中,nm23阳性表达22例(71.0%),KAI1阳性表达19例(61.3%).早期与中晚期患者的nm23和KAI1阳性表达率差异均有统计学意义(P确切=0.0051,P确切=0.0084),且两基因阳性率与临床分期呈负相关(P趋势=0.0047,P趋势=0.0058).高、中、低分化胆囊腺癌的nm23和KAI1阳性表达率差异均有统计学意义(P确切=0.0328,P确切=0.0020),且两基因阳性率与组织学分级呈正相关(P趋势=0.0086,P趋势=0.0006).术后3年,存活(17例)与死亡者(14例)的nm23和KAI1阳性表达率差异均有统计学意义(P确切=0.0038,P确切=0.0001),存活者中两基因均表达阳性15例,而死亡者中两基因均表达阴性7例(P确切=0.0005).结论 nm23和KAI1蛋白表达与胆囊腺癌的临床分期呈负相关,与组织学分级呈正相关.nm23和KAI1蛋白高表达预示胆囊腺癌患者预后较好,并且两基因有协同作用.

Expression of nm23 and KAI1 and their clinical significance in gallbladder adenocarcinoma

Objective To investigate the expression of two tumor metastasis suppressor genes nm23and KAI1 in gallbladder adenocarcinoma, and their clinicopathological significance. Methods Specimens and clinical data from 31 gallbladder adenocarcinoma patients were collected. Histopathological grading and the expression of nm23 and KAI1 were detected by HE and immunohistochemical staining, respectively. All cases were followed up for at least three years. Results Immunohistochemical staining showed that the positive rate of nm23 and KAI1 proteins was 71.0% (22/31) and 61.3% (19/31), respectively. The positive expression rates of nm23 and KAI1 proteins in the early stage carcinomas were significantly higher than those in the moderate and advanced stage ones (Pe,x,a,c,t=0.0051 and Pe,x,a,c,t=0.0084), and both had an negative correlation with clinicopathologic stage (Pt,r,e,n,d=0.0047 and Pt,r,e,n,d=0.0058). There was asignificant difference in the expression of nm23 and KAI1 proteins among well, moderately and poorly differentiated carcinomas (Pe,x,a,c,t=0.0328 and Pe,x,a,c,t=0.0020). The expression of nm23 and KAI1 was positively correlated with histopathological grade (Pt,r,e,n,d=0.0086 and Pt,r,e,n,d=0.0006). There was also asignificant difference in the expression of nm23 and KAII proteins between 17 survival and 14 dead patients(Pe,x,a,c,t=0.0038 and Pe,x,a,c,t=0.0001). A synergistic effect of nm23 and KAI1 protein on the survival was observed, and seemed to be more important than any individual gene alone (Pe,x,a,c,t=0.0005). Conclusion The expressions of nm23 and KAI1 proteins are negatively correlated with clinical stage, but positively with histopathological grade in gallbladder adenocarcinoma. These two tumor metastasis suppressor genes may act synergistically to inhibit the tumor metastasis.