鼻咽癌肿瘤组织中IgM 的表达及其临床意义

目的 检测鼻咽癌（NPC）组织中免疫球蛋白M（IgM）的表达，结合患者临床病理特征及生存预后，探讨其相互关系。方法 采用免疫组织化学SABC 法检测92 例NPC 组织中IgM 的表达，选取同期50例病理诊断为鼻咽部炎症组织作为对照，结合NPC 患者临床病理资料和预后情况进行分析。结果 NPC 组织中IgM 阳性表达率为68.48%，高于鼻咽部炎症组织的24.00%（P <0.05）。NPC 组织中IgM 表达多位于细胞浆，鼻咽部炎症组织则主要在细胞膜，且胞浆表达者多为低分化鳞癌，细胞膜表达者多为高、中分化磷癌。IgM表达与NPC 患者T 分期、临床分期有关（P <0.05），与鼻咽部或颈部复发及全身转移无关（P >0.05）。IgM表达阳性组的NPC 患者总体生存率（57.14%）高于IgM 表达阴性组（27.59%）（P <0.05），但两者无瘤生存率比较，差异无统计学意义（P >0.05）。结论 IgM 高表达于人NPC 组织；IgM 高表达可能参与NPC 早期发病过程，其是否表达可作为患者生存预后的指标。

Expression of IgM and its significance in human nasopharyngeal carcinoma tissues

Objective To detect the expression of IgM in nasopharyngeal carcinoma (NPC) tissues, and to explore its relationships with the clinicopathological characteristics and prognosis of NPC patients. Methods Immunohistochemical streptavidin-biotin-peroxidase complex (SABC) method was used to detect the expression of IgM in the NPC tissues of 92 patients, the pathologically-diagnosed nasopharyngeal inflammatory tissues of 50 cases were taken as controls. The results were analyzed in combination with clinical and pathological data and prognosis of the NPC patients. Results The positive expression rate of IgM in the NPC tissues was 68.48%, which was significantly higher than 24.00% of the nasopharyngeal inflammatory tissues (P < 0.05). The expression of IgM was mainly located in the cytoplasm in the NPC tissues, but in the cell membrane of the nasopharyngeal inflammatory tissues; and the cytoplasm expression mostly appeared in poorly-differentiated squamous cell carcinoma, and the cell membrane expression was mainly observed in the moderately- and well-differentiated NPC and the nasopharyngeal inflammatory tissues. The expression of IgM in the NPC tissues was negatively correlated with T stage and clinical stage (P < 0.05) in the patients with NPC and had nothing to do with local or cervical recurrence or distant metastasis (P > 0.05). The overall survival rate of the NPC patients with positive IgM expression was significantly higher than that of the NPC patients with negative IgM expression (57.14% vs. 27.59%, P < 0.05), but the diseasefree survival rate was not significantly different between the positive IgM expression group and the negative group (P > 0.05). Conclusions IgM is highly expressed in NPC. It is necessary to further study whether the different expression sites of IgM in NPC and different degree of differentiation are related to the function of the protein. The high expression of IgM may be involved in the early pathogenesis of NPC and can be used as an useful indicator for prognosis prediction of NPC patients.