黏蛋白3和黏蛋白4在结石相关肝内胆管细胞癌中的表达及意义

目的:探讨黏蛋白3(MUC3)和黏蛋白4(MUC4)在结石相关肝内胆管细胞癌(ICC)组织中的表达及临床意义。方法:用免疫组化法检测MUC3、MUC4在24例正常胆管组织、44例肝内肝管结石胆管组织、38例结石相关ICC组织中的表达,分析两者表达与ICC患者临床病理因素及预后的关系。结果:MUC3与MUC4在3种组织中的表达均有统计学差异(均P0.05),在正常胆管组织、结石患者胆管组织,结石相关ICC组织中MUC3的表达阳性率依次降低(79.2%、56.8%、36.8%),而MUC4的表达阳性率则相反(29.2%、79.5%、86.8%)。两者的表达均与结石相关ICC患者的肿瘤组织学分级、有无淋巴结转移有关,且MUC4的表达与门静脉有无浸润有关(均P0.05)。结石相关ICC患者中,MUC3阳性表达者术后生存率明显高于阴性患者,MUC4阳性表达患者术后生存率明显低于阴性表达患者(均P0.05)。结论:在结石相关ICC组织中,MUC3表达降低,而MUC4的表达升高,两者表达的变化与结石相关ICC的进展、侵袭及转移紧密相关。

Mucin-3 and -4 expressions in hepatolithiasis-associated intrahepatic cholangiocarcinoma and their significance

Objective: To investigate the expressions of mucin-3 (MUC3) and -4 (MUC4) in tissues of intrahepatic cholangiocarcinoma (ICC) associated with hepatolithiasis and their clinical significance. Methods: The MUC3 and MUC4 expressions in the 24 specimens of normal bile duct tissue, 44 specimens of bile duct tissue from hepatolithiasis patients, and 38 specimens of hepatolithiasis-associated ICC were determined by immunohistochemical staining. The relations of MUC3 and MUC4 expressions with clinical factors and prognosis of the patients with hepatolithiasis-associated ICC were analyzed. Results: The positive expression rates of both MUC3 and MUC4 were significantly different in the three different tissues (both P<0.05); in normal bile duct tissue, bile duct tissue from hepatolithiasis patients and hepatolithiasis-associated ICC tissue, the positive MUC3 expression rates were ranked in a decreasing order (79.2%, 56.8% and 36.8%), while the opposite was true for MUC4 (29.2%, 79.5% and 86.8%). In patients with hepatolithiasis-associated ICC, both MUC3 and MUC4 expressions were significantly related to the tumor histological differentiation and the presence or absence of lymph node metastasis, and MUC4 expression was also significantly related to the presence or absence of portal vein invasion (all P<0.05). In patients with hepatolithiasis-associated ICC, the postoperative survival rate in patients with positive MUC3 expression was significantly higher than that in patients with negative MUC3 expression, and in patients with positive MUC4 expression was significantly lower than that in patients with negative MUC4 expression (all P<0.05). Conclusion: The MUC3 expression is decreased and the MUC4 expression is increased in hepatolithiasis-associated ICC tissue, and the changes of their expressions are closely related to the development, invasion and metastasis of hepatolithiasis-associated ICC.