Snail在肝内胆管癌中的表达及其临床意义

目的:探讨Snail在肝内胆管癌组织中的表达及其与患者临床病理特征和生存预后的关系。方法:回顾性分析1999年12月—2010年1月外科手术治疗的55例肝内胆管癌病例及随访资料,免疫组织化学检测上述患者癌组织及癌旁组织标本中Snail的表达情况,分析Snail表达与临床病例资料、病理特征及预后的关系。结果:肿瘤组织中Snail表达量(2.764 vs.0.914)与高表达率(48.6%vs.18.0%)均明显高于癌旁组织(均P0.05),且Snail表达与肿瘤分化(χ~2=4.231,P=0.040)、TNM分期(χ~2=6.631,P=0.010)、淋巴结转移(χ~2=4.134,P=0.042)、微血管侵犯(χ~2=10.197,P=0.001)以及复发(χ~2=4.610,P=0.032)有关,与Snail低表达患者比较,Snail高表达患者总体生存率降低(P=0.018)、术后累计复发率升高(P=0.032)。单因素分析与多因素Cox回归模型分析结果示,微血管侵犯、淋巴结转移以及Snail表达是肝内胆管癌患者预后的独立影响因素(均P0.05)。结论:Snail在肝内胆管癌组织中表达增加,且Snail过表达与肝内胆管癌患者恶性病理特征及不良预后密切相关。

Snail expression in intrahepatic cholangiocarcinoma and its clinical significance

Objective: To investigate the Snail expression in intrahepatic cholangiocarcinoma (ICC) and its relations with clinicopathologic features and prognosis of the patients. Methods: The clinical and follow-up data of 55 ICC patients undergoing surgical treatment between December 1999 and January 2010 were retrospectively analyzed. The Snail expressions in specimens of tumor and adjacent tissues from these patients were determined by immunohistochemical staining, and the relations of Snail expression with the clinicopathologic characteristics and prognosis of the patients were statistically analyzed. Results: In tumor tissues compared with their adjacent tissues, both the expression level (2.764 vs. 0.914) and high expression rate of Snail (48.6% vs. 18.0%) were significantly increased (both P<0.05), and Snail expression was significantly associated with the tumor differentiation (χ2=4.231, P=0.040), TNM stage (χ2=6.631, P=0.010), lymphatic metastasis (χ2=4.134, P=0.042), microvascular invasion (χ2=10.197, P=0.001) and recurrence (χ2=4.610, P=0.032); the postoperative overall survival rate was decreased (P=0.018) and accumulative recurrence rate was increased (P=0.032) in patients with high Snail expression compared with those with low expression. Results of univariate and multivariate Cox regression analysis revealed that microvascular invasion, lymphatic metastasis and Snail expression were independent influential factors for prognosis of the patients (all P<0.05). Conclusion: Snail expression is increased in ICC tissue, and its overexpression is closely related to malignant pathological profiles and dismal prognosis of the ICC patients.