胃肠道类癌中激素蛋白的表达及意义

目的:探讨消化道类癌激素蛋白的表达及其临床意义。方法:应用免疫组化SP法对36例消化道类癌组织中6种蛋白进行检测。结果:36例类癌组织中,生长抑素在典型、非典型和低分化3组类癌中阳性表达率分别是71·4%(10/14)66·7%(8/12)和20·0%(2/10),3组比较差异有统计学意义,P=0·028。生长抑素阳性标记率在进展期类癌和有淋巴结转移类癌分别为25·0%(4/16)、25·0%(3/12),显著低于早期类癌和无淋巴结转移类癌,其阳性表达率分别随组织分化降低而上升典型、非典型和低分化3组类癌比较胃泌素阳性率分别是57·1%(8/14)、83·3%(10/12)和100·0%(10/10),P=0·038,降钙素阳性率分别是0(0/14)、8·3%(1/12)和50·0%(5/10),P=0·003,差异有统计学意义。早期和进展期类癌比较,胃泌素和降钙素阳性表达率分别为65·0%(13/20)93·8%(15/16)和10%(2/20)、37·5%(6/16),P值分别为0·039和0·049。有无淋巴结转移比较,胃泌素和降钙素阳性表达率分别为100%(12/12)、66·7%(16/24)和41·7%(5/12)、12·5%(3/24),P值分别为0·023和0·047,差异均有统计学意义结论:在类癌组织中胃泌素和降钙素高表达,生长抑素的低表达可能与肿瘤的组织分化、侵袭和浸润有关,它们的异常表达可预测肿瘤的生物学行为。

Expression of hormonal protein and its significance in gastrointestinal carcinoid

OBJECTIVE:To study the relationship between the expression of hormonal protein and biological behavior in gastrointestinal carcinoid. METHODS: The immunohistochemistry SP method was adopted to examine the expressions of six different proteins in thirty-six cases of gastrointestinal carcinoid. RESULTS: In thirty-six cases of gastrointestinal carcinoid, the positive rates of somastatin expression were 71.4%(10/14),66.7%(8/12) and 20.0%(2/10)in typical carcinoid, atypical carcinoid and low differentiation carcinoid, respectively, showing significant correlation, P=0.028. The positive rates of somastatin expression were 25.0%(4/16)and 25.0%(3/12) in progressing tumor and lymph metastasis tumor, decreasing with the early tumor and without lymph metastasis tumor, and the positive rates of somastatin expression were 80.0%( 16/20 ) and 70.8%(17/24),P=0.001,0.009, respectively. For gastrin and calcitonin, the positive rates increased with the poor differentiation and the positive rates of gastrin expression were 57.1%(8/14), 83.3%( 10/12 )and 100.0%(10/10,P=0.038. The positive rates of calcitonin expression were 0(0/14), 8.3%(1/12) and 50.0%(5/10),P=0.003 in typical carcinoid, atypical carcinoid and low differentiation carcinoid, respectively,showeing significant correlation. In early and progressed carcinoid, the positive rates of gastrin and calcitonin expressions were 65.0%(13/20), 93.8%( 15/16 ) and 10%(2/20), 37.5%(6/16),P=0.039, 0.049, respectively. The positive rates of gastrin and calcitonin expressions were 100%(12/12), 66.7%(16/24) and 41.7%(5/12), 12.5%(3/24),P=0.023, 0.047 respectively with lymph node metastasis and without lymph node metastasis. CONCLUSION:The high expressions of gastrin and calcitonin and low expression of somastatin may be associated with the differentiation, invasion and metastasis of gastrointestinal carcinoid. These data indicate that the expressions of gastrin, calcitonin and somastatin may be valuable markers to predict the biologic behavior and prognosis of gastrointestinal carcinoid.