乙酰肝素酶在胆囊癌中的表达及临床意义

目的：探讨乙酰肝素酶（heparanase，Hpa）在胆囊癌中的表达及对预后的影响。方法：用免疫组化方法检测38例手术切除的胆囊癌标本中Hpa的表达，并分析其与临床病理特征的关系。结果：Hpa在胆囊癌，癌旁组织以及正常胆囊黏膜组织中表达率分别为63．2％，23．6％和0（P〉0．05）。单因素分析显示Hpa的表达增高与肿瘤分期晚（P=0．007），淋巴结转移（P=0．040）以及肿瘤浸润深度（P=0．016）密切相关。高表达Hpa的患者3年生存率较低表达患者明显降低（20．8％VS50．0％，P=0．001）。多因素分析显示Hpa的表达不是胆囊癌预后的独立因素（P〉0．05）。结论：Hpa在胆囊癌中表达增高，并与患者预后呈负相关。Hpa的表达增高可以部分解释胆囊癌富于浸润和转移的生物学行为。

Heparanase expression and clinical significance in gallbladder carcinoma

Objective：To analyze the expression and explore the prognostic value of heparanase in gallbladder cancer. Methods： Heparanase protein level in 38 patients with gallbladder carcinoma was detected by immunohistochemistry and analyzed for elinicopathologieal significance. Results： The heparanase protein expression in gallbladder cancer, adjacent tissue around the tumor and normal tissue were 63.2 % ,23.6% and 0 respectively （P 〉 0.05 ）. High heparanase expression was closely related to advanced TNM stage （ P = 0. 007 ）, depth of tumor invasion （ P = 0. 016） and lymph node metastasis （P = 0.040）. Patients with high heparanase expression had a decreased postoperative survival at 3 years than those with negative heparanase expression （20.8% vs 50.0% ,P =0.001 ）. Multivariate analysis showed that heparanase expression was not an independent prognostic factor （ P 〉 0.05 ） . Conclusion： Heparanase protein is highly expressed in gallbladder carcinoma and associated with decreased survival rate. High expression of heparanase may contribute to the highly invasive and metastastic behavior of gallbladder carcinoma.