p53、E-cadherin和MMP7在胆囊癌中的表达及意义

目的检测p53、E—cadherin和MMP7在胆囊癌组织中的表达情况，探讨它们与胆囊癌的发生、发展、局部浸润、远处转移及预后的关系，以及它们之间的相关性。方法用免疫组化法（SP法）检测54例胆囊癌组织中p53、E—cadherin和MMP7的表达情况。结果54例原发性胆囊癌组织中p53、E—cadherin和MMP7阳性表达率分别为48．1％、59．3％和94．4％。p53过度表达与胆囊癌分化程度、临床分期有关；E—cadherin表达下降或完全丧失与临床分期、神经浸润及淋巴结转移有关；MMP7表达升高与临床分期、分化程度、肝脏浸润、神经浸润及淋巴结转移有关。相关分析表明MMP7与E—cadherin的表达呈负相关。生存分析提示MMP7的阳性表达、肿瘤TNM分期、肝脏浸润、神经浸润及淋巴结转移与术后生存率有关，Cox多因素分析表明TNM分期、神经浸润与胆囊癌患者的预后有关。结论p53、MMP7及E-cadherin可作为胆囊癌重要的恶性生物学指标；MMP7与E—cadherin的表达呈负相关；MMP7的表达可提示胆囊癌患者的预后，并可为胆囊癌患者抗基质金属蛋白酶治疗提供依据。

Expression and clinical significance of p53, E-cadherin and MMP7 in carcinoma of gallbladder

Purpose To detect the expression of p53, E-cadherin and MMP7 and to discuss the correlation of them in carcinoma of gallbladder, and then to evaluate the relationships with pathogenesis, invasion, metastasis and prognosis. Methods immunohistochemical staining was used to detect the expression of p53, E-cadherin and MMP7 in 54 cases of primary carcinoma of gallbladder. Results The positive rate of p53, E-cadherin and MMP7 was 48. 1% , 59. 3% and 94.4%, respectively in 54 cases of carcinoma of gallbladder. The over-expression of p53 was correlated to the differentiation and clinical stage. The abnormal or decreased expression of E-cadherin was correlative with clinical stage, nerve invasion and lymph node metastasis. The over-expression of MMP7 was correlative with clinical stage, differentiation, liver and nerve invasion, and lymph node metastasis. The Spearman correlation analysis suggested that the expression of MMP7 and E-cadherin was negatively correlated. The survival analysis indicated that the expression of MMP7, clinical stage, liver and nerve invasion, and lymph node metastasis were associated with survival rate of post-operation. Cox regression indicated that clinical stage and nerve invasion were beth correlated with prognosis of carcinoma of gallbladder patients. Conclusions p53, E-cadherin and MMP7 may be significant malignant markers for carcinoma of gallbladder. The relationship between MMP7 and Ecadherin is negatively correlated. MMP7 may be a useful prognostic marker for patients with gallbladder carcinoma, and its detection may be useful for selecting patients for anti-matrix metalloproteinase therapy.