鼻咽癌ＫＤＲ受体信号传导相关蛋白的表达及意义*

目的　分析鼻咽癌组织中ＫＤＲ及其下游信号分子ＰＫＣ-β和ｐ-ＥＲＫ的表达，并探讨上述蛋白表达与鼻咽癌患者临床特征和生存期的关系。方法　免疫组织化学法检测１１０例鼻咽癌和３０例鼻咽良性病变石蜡切片中ＫＤＲ、ＰＫＣ-β和ｐ-ＥＲＫ的表达情况，用Ｓｐｅａｒｍａｎ法分析它们之间的相关性，Ｋａｐｌａｎ-Ｍｅｉｅｒ法计算生存情况，行Ｌｏｇ-ｒａｎｋ检验和Ｃｏｘ比例风险模型分析。结果　鼻咽癌组织中ＫＤＲ、ＰＫＣ-β和ｐ-ＥＲＫ阳性表达率分别为８８.２％（９７／１１０）、６３.６％（７０／１１０）和５１.８％（５７／１１０），而在鼻咽良性病变阳性表达率低。鼻咽癌组织中ＫＤＲ表达与ＰＫＣ-β及ｐ-ＥＲＫ表达呈正相关（ｒ＝０.２９７，Ｐ＝０.００２；ｒ＝０.３３６，Ｐ＜０.００１），ＰＫＣ β表达与ｐ ＥＲＫ表达呈正相关（ｒ＝０.３０１，Ｐ＝０.００１）。ＫＤＲ和ｐ-ＥＲＫ表达与原发肿瘤的侵犯范围相关（Ｐ＜００５）；ＰＫＣ β和ｐ ＥＲＫ表达与临床分期相关（Ｐ＜０.０５）；ＫＤＲ和ＰＫＣ-β表达与肿瘤局部复发或远处转移相关（Ｐ＜０.０５）。３种蛋白表达均与总生存不佳相关（Ｐ＜０.０５）。Ｃｏｘ多因素相关分析显示年龄＞５０岁为不良预后因素（Ｐ＜０.０５）。结论　ＫＤＲ及其下游信号分子ＰＫＣ-β和ｐ-ＥＲＫ在鼻咽癌中表达，与鼻咽癌患者的临床特征和预后关系密切。

Expression and prognostic significance of KDR and it's signal transduction related proteins in nasopharyngeal carcinoma

Objective To explore the correlation of KDR and its down-stream signal transduction proteins（PKC-β and p-ERK） expression to clinical features and survival of nasopharyngeal carcinoma（NPC） patients. MethodsImmunohistochemistry method was adopted to detect expression of KDR,PKC-β and p-ERK in formalin fixed,paraffin embedded specimens from 110 patients with NPC and 30 patients with benign nasopharyngeal disease.SPSS 13.0 statistical software was used to analyze their correlation to clinical features and overall survival of NPC patients by spearman method,Kaplan-Meier method and Cox model. ResultsKDR,PKC-β and p-ERK were expressed respectively in 88.2%（97/110）,63.6%（70/110） and 51.8%（57/110） NPC patients,which were lower in benign nasopharyngeal disease patients.KDR expression was positively related with expression of PKC-β and p-ERK（r=0.297,P=0.002;r=0.336,P0.001,respectively）.PKC-β expression was positively related with expression of p-ERK（r=0.301,P=0.001）.KDR and p-ERK expression were related with primary tumor site（P0.05）;PKC-β and p-ERK expression were related with clinical stage（P0.05）;KDR and PKC-β expression were related with local recurrence and/or distant metastasis（P0.05）.All of them were related with poor overall survival in NPC patients（P0.05）.Cox multivariate analysis showed age more than 50 years was an independent prognostic factor（P0.05）. ConclusionKDR and its downstream signal transduction proteins（PKC-β and p-ERK） express in NPC tissue and positively relate with clinical features and prognosis of NPC patients.