EpCAM和E-cadherin在膀胱尿路上皮癌的表达及意义

【摘要】目的 探讨上皮特异性黏附分子（EpCAM）和E-钙黏素（E-cadherin）在膀胱癌中的表达及临床意义。方法应用免疫组织化学SP法检测156例不同级别膀胱癌组织和80例癌旁正常组织中EpCAM和E-cadherin的表达，分析 它们在不同临床病理因素膀胱癌中的表达情况，及两者在膀胱癌发展过程中的相互关系。结果 膀胱癌组织中EpCAM表达高于癌旁组织（53.2% vs 13.8%，P＜0.01），膀胱癌组织中E-cadherin表达低于癌旁组织（35.9% vs56.3%，P＜0.01）。高分级膀胱尿路上皮癌标本中可见较为典型的EpCAM高表达，低分级膀胱尿路上皮癌中可见典型E-cadherin阳性表达。EpCAM在肌层浸润性(pT2、pT3 或pT4)、高分级、合并远处转移、多发及复发膀胱肿瘤中表达上调（P＜0.05），E-cadherin在肌层浸润性、高分级、合并远处转移、多发膀胱肿瘤中表达下调（P＜0.05）。膀胱癌中EpCAM与E-cadherin的表达呈负相关(r = -0.607, P < 0.01)。结论 EpCAM和E-cadherin与膀胱癌的分化、浸润转移等恶性行为有关, 两者联合检测对判断肿瘤侵袭转移能力具有一定价值。

Clinicopathologic Significance of EpCAM and E-cadherin Expression in Urothelial Carcinoma of Bladder

[Abstract] Objective To investigate the expressions of the epithelial cell adhesion molecule (EpCAM) and E-cadherin and their clinical significance in urothelial carcinoma of bladder. Methods The expressions of EpCAM and E-cadherin were analyzed by immunohistochemistry using a monoclonal antibody EpCAM and E-cadherin in 80 cases of normal mucosa and 156 cases of urothelial carcinoma of bladder. The expression levels of EpCAM and E-cadherin were analyzed in different clinical pathological factors. Moreover, EpCAM expression was investigated by comparison with E-cadherin. Results The positive rate of EpCAM expression in bladder urothelial carcinoma was 53.2%, which was significantly higher than that in para-cancerous mucosa (13.8%，P＜0.01). The positive rate of EpCAM expression was significantly lower in bladder urothelial carcinoma than that in para-cancerous mucosa (35.9% vs 56.3%，P＜0.01). The positive expression of EpCAM was detected in high-grade urothelial carcinoma. The positive expression of E-cadherin was detected in low-grade urothelialcarcinoma. The expression levels of EpCAM increased with the increased clinical stages, pathological grades, tumor quantity,distant metastasis and tumor recurrence (all P< 0.05). The expression levels of E-cadherin decreased with the increased clinical stages, pathological grades, tumor quantity and distant metastasis (all P< 0.05). There was a negative correlation between expressions of EpCAM and E-cadherin in bladder urothelial carcinoma (r =-0.607, P < 0.01). Conclusion The expressions of EpCAM and E-cadherin are associated with tumor malignancies, such as invasion and metastasis. The evaluation of the two markers has a certain value for determining tumor invasion and metastasis.