Laminin和survivin的表达与胆囊癌临床病理特征的关系

目的:研究laminin和survivin蛋白在原发性胆囊癌组织中的表达情况,及其与癌组织类型、病理分级和转移状况的关系。 方法:应用免疫组织化学方法检测49例原发性胆囊癌、21例胆囊腺瘤和13例慢性胆囊炎组织中laminin和survivin蛋白的表达。 结果:胆囊黏膜内癌或原位癌细胞基底膜laminin线性染色完整；NevinⅡ期胆囊癌组织表现为基底膜不完整,变薄,断裂,或缺损；临床NevinⅢ、Ⅳ、Ⅴ期胆囊癌，则无基底膜形成，在肿瘤组织周围，laminin表达类型呈碎片状或断线状和连续线状，部分癌组织内laminin染色消失和癌细胞浆内有laminin弱染色。胆囊癌组织中survivin阳性表达率明显高于胆囊腺瘤和慢性胆囊炎组织，但survivin的阳性表达与胆囊癌细胞分化程度、病理分级和转移无关(P>0.05)。且胆囊癌组织中laminin的连续线断裂或缺失,与胆囊癌组织中survivin的表达情况无相关性。 结论:胆囊癌基质中laminin的表达类型与胆囊癌的侵袭和转移有关，而survivin在胆囊癌中表达增加，但两者之间似乎无关联。 

Expression of laminin and survivin in primary gallbladder carcinoma

AIM:To study the expression of laminin and survivin in primary gallbladder carcinoma (PGC), and their correlation with clinicopathologic characteristics of PGC. METHODS:Forty-nine specimens with PGC, 21 with cholecystoadenoma and 13 with chronic cholecystitis were included in this study. Laminin and survivin expression in gallbladder tissues were detected by immunohistochemistry. The relationship between laminin or survivin expression and clinico-pathologic data were also analyzed. RESULTS:An intact basement membrane (BM) with well-delineated, smooth and continuous line-like laminin staining was identified in the tissues from chronic cholecystitis, adenoma of gallbladder and gallbladder carcinoma in situ. Submucosal BM, which was interrupted in PGC specimens in NevinⅡstage, was almost lost in tumor tissues in Nevin Ⅲ, Ⅳ and Ⅴ stage. Meanwhile, a distinguishing feature of the tumor tissue was broken or discontinuous line-like laminin staining in the matrix to tumor cells. These lines were detected to be weak, or even entirely absent in some neoplastic tissue sections. Sometimes, a faint cytoplasmic staining of laminin was also found in tumor tissues as classified to Nevin Ⅲ, Ⅳ and Ⅴ stage. Expression of survivin in PGC tissues was significantly higher than that in adenoma of gallbladder and chronic cholecystitis. However, survivin expressions had no specificity and positive predictive value for cell differentiation and grade as well as clinic stage of PGC by using statistical analyses. Furthermore, no correlation was confirmed between the staining features of laminin and survivin expression. CONCLUSION:Laminin expression is strongly associated with the malignancy and invasiveness of PGC, and survivin might play an important synergistic role in the development of PGC.