尿激酶型纤溶酶激活物及受体在外阴肿瘤中的表达及意义

目的 研究尿激酶型纤溶酶激活物(uPA)及其受体(uPAR)在外阴组织中的表达变化及临床意义。方法 取1995至2011年在河北医科大学第三医院和河北省衡水市哈励逊国际和平医院住院的30例外阴恶性肿瘤的癌组织、30例外阴上皮内瘤变(VIN)的肿瘤组织,以30例正常外阴上皮组织为对照。采用免疫组化的方法 ,通过在石蜡包埋组织中检测uPA、uPAR两种蛋白的表达情况,观察不同外阴组织的表达变化,在临床分期、淋巴结转移等方面进行对照分析比较其有无差异。结果 (1)uPA和uPAR的表达（A值）分别在正常组织(0.422±0.022,0.431±0.027)、外阴上皮内瘤变(VIN) (0.462 ±0.018,0.467±0.015)及外阴恶性肿瘤中(0.508±0.020,0.510±0.020)的差异均有统计学意义（均P＜0.01）。(2)uPA和uPAR在外阴恶性肿瘤组织中的表达随分期级别升高而增强,差异有统计学意义(P＜0.05)。(3)uPA和uPAR在外阴恶性肿瘤组织中的表达,有淋巴结转移组显著高于未转移组(P＜0.05)。结论 uPA、uPAR在正常外阴组织、VIN及外阴恶性肿瘤的表达中的升高趋势,提示其可能在外阴恶性肿瘤发生及发展过程中发挥重要作用;检测组织中uPA、uPAR含量可评估外阴恶性肿瘤的浸润能力及预后状况。

Expressions and clinical significance of urokinase-type plasminogen activator and its receptor in vulvar tissues

Objective To explore the expressions of urokinase-type plasminogen activator (uPA)and its receptor (uPAR) in vulvar tissues and elucidate the patterns. Methods Thirty cases of vulvar neoplasms, 30 vulvar intraepithelial neoplasia (VIN) and 30 cases of normal epithelial tissue were harvested. And the expressions of uPA and uPAR in paraffin-embedded tissues were detected by immunohistochemistry. And the differential expressions of various vulvar tissues were observed. And the differences were compared in clinical stage and lymph node metastasis. Results ( 1 ) The expressions of uPA and uPAR in normal tissues (0.422 ±0.022, 0.431 ±0.027), vulvar intraepithelial neoplasia (VIN)(0.462 ±0.018, 0.467 ±0.015) and vulvar neoplasms (0.508 ±0.020, 0.510 ± 0.020) were significantly different (P ＜0.01 ). (2) The expressions of uPA and uPAR in vulvar tissue significantly increased with a rising stage-level (P ＜ 0.05 ). ( 3 ) Compared with those without lymph node metastasis ,the patients with lymph node metastasis bad significantly higher expressions of uPA and uPAR in vulvar tissue ( P ＜ 0.05). Conclusion Thus uPA and uPAR play an important role in the development process of vulvar neoplasms with an elevated expression in normal vulvar tissue, VIN and vulvar neoplasms. The invasiveness and prognosis of vulvar neoplasms may be evaluated through detecting the tissue expressions of uPA and uPAR.