肿瘤干细胞标记蛋白ALDH1在浸润性膀胱癌组织中的表达及其与临床病理和预后的关系 

目的: 探讨肿瘤干细胞标记物乙醛脱氢酶1（ALDH1）在浸润性膀胱癌组织中的表达，阐明其与膀胱癌生物学行为的关系。方法： 采用免疫组织化学方法检测109例浸润性膀胱癌组织和20例癌旁正常膀胱组织(对照组)中ALDH1蛋白的表达，同时检测6例癌转移淋巴结组织及20例未转移淋巴结组织中ALDH1的表达，分析ALDH1蛋白表达与浸润性膀胱癌患者临床病理特征的关系及其对患者总生存率和无瘤生存率的影响。 结果： ALDH1蛋白阳性表达率，在膀胱癌与正常膀胱组织中分别为33.94%(37/109)和5.00%(1/20)，差异有统计学意义（P<0.01）；在非肌层浸润性与肌层浸润性膀胱癌中分别为19.05%(8/42)和43.28%(29/67)，差异有统计学
意义（P<0.01）；在低级别与高级别膀胱癌中分别为13.04%(3/23)和39.53%(34/86)，差异有统计学意义（P<0.05）；在淋巴转移组与淋巴未转移组膀胱癌组织中分别为50.00%(3/6)和12.90%(4/31)，差异有统计学意义（P<0.05）；在转移淋巴结及未转移淋巴结组织中分别为50.00%(3/6)和0.00%(0/20)，差异有统计学意义（P<0.01）。术后随访4~65个月，经Kaplan-Merier分析，ALDH1蛋白阳性表达组患者总生存率为64.9%，阴性表达组为84.7%，差异有统计学意义（P<0.05）；ALDH1蛋白阳性表达组患者总体无瘤生存率为51.40%，阴性表达组为75.00%，差异有统计学意义（P<0.05)。 结论： 肿瘤干细胞标记蛋白ALDH1高表达与浸润性膀胱癌分期和分级及预后有关联，是浸润性膀胱癌预后不良的重要因素。

Expression of tumor stem cell marker ALDH1 in invasive bladder cancer tissue and its relationship with clinicopathological parameters and prognosis

Objective To study the expression of tumor stem cell marker aldehyde dehydrogenase 1(ALDH1)in invasive bladder cancer tissue and to clarify its relationship with the biological behavior of bladder cancer.Methods The ALDH1expression in 109cases of primary invasive carcinomas specimens(case group)and 20cases of normal bladder tissue surrounding cancer(control group)was detected by immunohistochemistry.At the same time,the ALDH1expression in 6cases of metastatic pelvic lymph node tissue and 20cases of non-metastatic pelvic lymph node tissue was detected.The relationship between the ALDH1expression and the chinicopathological charateristics of invasive bladder cancer and its influence in the survival rate and disease-free survival were analyzed.Results The positive rates of ALDH1expression in bladder cancer tissue and normal bladder tissue were 33.94%(37/109)and 5.00%(1/20),respectively,there was significant different between them(P<0.01);they were19.05%(8/42)and 43.28%(29/67)in the cases with non muscle invasive and nmuscle invasive bladder cancer,respectively,there was significant difference(P<0.01);they were 13.04%(3/23)and 39.53%(34/86)in the cases of bladder cancer with low grade and high grade,respectively,there was significant difference(P<0.05);they were 50.00%(3/6)and 12.90%(4/31)in the tissue of bladder cancer with metastatic lymph nodes and non metastatic ones,respectively,there was significant difference(P<0.05);they were 50.00%(3/6)and 0.00%(0/20)in the metastatic lymph nodes and non metastatic ones,respectively,there was significant difference(P<0.01).The overall survival rate in the patients with positive ALDH1expression was 64.9% while it was 84.7%in negative ones,there was significant difference(P<0.05);the disease-free Survival was 51.4% and 75%in the patients with positive and negative ALDH1groups,respectively,there was significant difference(P<0.05).Conclusion The high expression of tumor stem cell marker ALDH1is associated with staging,grading and prognosis of invasive bladder cancer.ALDH1may play a role in the tumorigenesis,progression and metastasis of bladder cancer.