肝门部胆管癌相关蛋白表达及微血管密度的临床病理学研究

目的 探讨肝门部胆管癌相关蛋白表达及微血管密度与肿瘤临床病理特征的关系.方法 免疫组织化学SP 法观察75 例肝门部胆管癌(hilar cholangiocarcinoma,HCCA) 肿瘤相关基因产物Her-2、P170、VEGF、突变型P53 蛋白、Ki-67、Top-Ⅱα的表达情况;用CD34 抗体标记血管内皮细胞,并检测微血管密度(microvessel density,MVD),分析其与肿瘤病理特征的相关性,Kappa 和Kruskal-Wallis 法分别检验Ki-67、Top-Ⅱα对肿瘤细胞增殖程度的检验效果和不同分化程度组肿瘤MVD 的差异.结果 Her-2、P170、VEGF 和突变型P53 蛋白阳性表达率分别为21.7%、51.2%、36% 和48.8% ;Ki-67、Top-Ⅱα蛋白阳性表达率分别为93.3% 和83.7%,两者对胆管癌细胞增殖程度的检验效果一致性较好(P=0.001) ;高分化腺癌与中、低分化腺癌组MVD 之间差异有统计学意义(P=0.022),而中、低分化组之间差异无统计学意义(P=0.267).结论 肿瘤相关蛋白的表达及肿瘤微血管密度与肝门部胆管癌的病理特征密切相关,可作为评价肿瘤生物学特性的指标;Ki-67 与Top-Ⅱα对肿瘤增殖程度的检测效果相当.

Correlation between expression of hilar cholangiocarcinoma-associated proteins and microvessel density: A clinicopathological study

Objective To study the correlation between expression of hilar cholangiocarcinoma(HCCA)-associated proteins,microvessel density(MVD) and clinocopathological characteristics of HCCA.Methods Expressions of HCCA-associated gene products,including Her-2,P170,VEGF,mutant P53,Ki-67,and Top-Ⅱα in 75 HCCA patients were detected with immunohistochemitry SP method.Vascular endothelial cells were marked with CD34 antibody.MVD was measured and its correlation with pathological characteristics of HCCA was analyzed.Effect of Ki-67 and Top-Ⅱα on proliferation of HCCA cells was detected with Kappa and Kruskal-Wallis method,respectively.Results Protein Her-2(21.7%),P170(51.2%),VEGF(36%) and mutant P53(48.8%) were detected to express in the specimens,respectively.Ki-67(93.3%) and Top-Ⅱα(83.7%) were also detected to express in the specimens,and there was a good concordance between Ki-67 and Top-Ⅱα in detecting the proliferation of tumor through Kappa analysis(P=0.001).The expression rate of MVD was significantly lower in well-differentiated adenocarcinoma than in moderately and poorly differentiated adenocarcinoma(P<0.05),while no significant difference was observed in MVD expression between moderately and poorly differentiated adenocarcinomas(P>0.05).Conclusion The expression of HCCA-associated proteins is closely related with the MVD and pathological characteristics of HCCA and can be used as an index in assessing the biological characteristics of HCCA.The effect of Ki-67 and Top-Ⅱα expression is similar on proliferation of HCCA.