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目的研究人端粒酶逆转录酶(hTERT)、Ki-67及p27kip1的表达在嗜铬细胞瘤发生与发展中的作用和作为预测生物学行为标志物的价值。方法采用免疫组织化学方法检测hTERT、Ki-67及p27kip1在2000—2004年广西医科大学第一附属医院病理科的45例嗜铬细胞瘤和神经节细胞瘤及9例正常肾上腺组织中的表达。结果hTERT蛋白的表达在良性(3/31例)和可疑恶性(6/7例)以及良性与恶性肿瘤(5/7例)间的差异均有统计学意义(P<0.01)。31例良性肿瘤中26例未检测到Ki-67,而恶性肿瘤和可疑恶性肿瘤均为阳性;Ki-67与hTERT的表达呈正相关性(r=0.544,P<0.01)。恶性和可疑恶性肿瘤中未检测到p27kip1,5例良性肿瘤为阳性,所有正常肾上腺髓质标本均可检测到p27kip1的表达。p27kip1与hTERT的表达无相关性。结论端粒酶的激活在恶性嗜铬细胞瘤和神经节细胞瘤的发生发展中起着重要作用,在细胞周期调控中端粒酶可能存在不同的激活途径。hTERT和Ki-67的检测可作为鉴别良恶性嗜铬细胞瘤的手段。
Objective To investigate the role of hTERT, Ki-67 and p27kip1 expression in the pathogenesis and development of pheochromocytoma and their value as predictors of biological behavior. Methods Immunohistochemistry was used to detect the expression of hTERT, Ki-67 and p27kip1 in 45 cases of pheochromocytoma and 9 cases of normal adrenal gland in the pathology department of the First Affiliated Hospital of Guangxi Medical University from 2000 to 2004. Results The expression of hTERT protein in benign (3/31 cases), suspicious malignant (6/7 cases) and benign and malignant tumors (5/7 cases) showed statistically significant difference (P <0.01). Ki - 67 was not detected in 26 of 31 benign tumors, while both malignant tumors and suspicious malignant tumors were positive. There was a positive correlation between Ki - 67 and hTERT (r = 0.544, P <0.01). No malignant and suspicious malignant tumors were detected p27kip1, 5 cases of benign tumors were positive, all normal adrenal medulla specimens can be detected p27kip1 expression. There was no correlation between p27kip1 expression and hTERT expression. Conclusion The activation of telomerase plays an important role in the development of malignant pheochromocytoma and gangliocytoma. There may exist different activation pathways of telomerase in cell cycle regulation. The detection of hTERT and Ki-67 can be used as a means of differentiating benign and malignant pheochromocytomas.