乙酰肝素酶在头颈部鳞状细胞癌的表达及其临床意义

目的探讨乙酰肝素酶（heparanase，HPSE）在头颈部鳞癌的表达与临床病理特征及预后的关系。方法对62例头颈肿瘤手术切除标本进行检测，采用免疫组化技术检测HPSE在原发肿瘤组织及其淋巴转移灶中的表达，分析HPSE的表达同患者的年龄、临床分期、病理分级、有无淋巴转移及与预后的关系。结果HPSE在癌旁黏膜组织中不表达或少表达，在大多数头颈肿瘤组织中呈阳性表达，阳性表达率为69．3％（43／62），主要为胞质表达。HPSE的表达在患者的年龄、肿瘤的病理分级方面比较，差异无统计学意义（Х^2=0．05，Х^2=3．84，P值均〉0．05）；而在有无淋巴转移以及肿瘤的临床分期方面差异有统计学意义（Х^2=3．98，Х^2=8．06，P值均〈0．05）；HPSE在原发灶及其淋巴转移灶中的表达之间呈明显正相关（r=0．9162，P=0．001）；Kaplan—Meier法计算，HPSE阳性组的3年累积生存率为25．9％，HPSE阴性组的3年累积生存率为72．7％，二者差异有统计学意义（Х^2=11．607，P=0．001）。HPSE的表达和肿瘤的TNM临床分期分别为影响预后的独立因素，二者分别与患者的预后显著相关（Х^2值分别为16．86和19．73，P值均〈0．05）。结论HPSE在头颈鳞癌中表达显著增高。HPSE的表达与有无淋巴转移、肿瘤的临床分期密切相关。HPSE的表达、肿瘤的临床分期是影响患者预后的独立因素。

Expression of heparanse on the squamous cell carcinoma of head and neck and its clinical significance

OBJECTIVE: To investigate the relationship among expression of heparanse (HPSE), the clinical and pathologic characterastics of squamous carcinoma on head and neck and the patients' prognosis. METHODS: Sixty-two cases of postoperative tumor specimens were verified by immunohistochemistory S-P method and computer-assisted image analysis method was used. RESULTS: The expression of HPSE in normal epithelium mucosae of head and neck was negative or very weak; in tumor tissue was postive, mainly in cytoplasm and the positive rate was 69.3%. The expression of HPSE hadn't significant difference with the age of patients and pathologic grades of tumors (chi2 = 0.05, chi2 = 3.84, P > 0.05), but had it with clinical stages and metastatic lymph node lesions (chi2 = 3.96, chi2 = 8.06, P < 0.05). The relationship between expression of HPSE in primary tumors and that in metastatic lymph node lesions showed significantly positive correlation (r = 0.9162, P = 0.001). Both HPSE and TNM clinical stage of tumor had significant correlation with the prognosis of patients respectively (P < 0.05). Calculated by Kaplan-Meier method, the accumulative survival rate of 3 years in positive HPSE expression group (25.9%) was much lower than that in negative group (72.7%), there was a significant difference between them by Log-Rank test (chi2 = 11.607, P < 0.001). CONCLUSIONS: The expression of HPSE is significantly increased in squamous carcinomas of head and neck, mainly expressed in cytoplasm. The expression of HPSE has a close relationship with clinical stages and lymph node metastasis of squamous carcinoma on head and neck. The higher the clinical stage, the more manifest the expression of HPSE. The expression of HPSE and TNM clinical stage of tumor are independent factors affecting prognosis.