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目的通过检测肝素酶-1(HPA)、环氧化酶-2(CoX-2)、微血管密度(MVD)在良、恶性嗜铬细胞瘤中的表达情况,探讨HPA、CoX-2能否成为一种预判恶性嗜铬细胞瘤的指标,并阐明三者间的相互关系。方法选取1986年10月～2006年8月住院经手术治疗、且有完整的临床、病理和随访资料的嗜铬细胞瘤患者存档石蜡标本38例,其中良性嗜铬细胞瘤21例,恶性嗜铬细胞瘤17例。恶性组中首次手术确诊为嗜铬细胞瘤后随访28～179月,良性组中首次手术确诊为嗜铬细胞瘤后随访93～264月;另取20例因良性肾疾患行肾切除时获取的同侧正常肾上腺组织作为对照组。采用免疫组织化学技术,检测良、恶性嗜铬细胞瘤及对照组中HPA、CoX-2和MVD的表达情况。结果 HPA在恶性组中表达最高,在良性组中表达较低,在对照组中无表达,恶性组与良性组及恶性组与对照组之间HPA的表达有显著性差异(P<0.05)。CoX-2在恶性组中表达最高,良性组中表达较低,对照组中无表达,恶性组与良性组及恶性组与对照组之间CoX-2的表达差异有统计学意义(P<0.05)。MVD在恶性组中呈高表达,在良性组中次之,在对照组中最低,MVD在恶性组中的表达与在良性组和对照组中的表达有显著性差异(P<0.05)。在嗜铬细胞瘤中HPA与CoX-2和MVD的表达两两之间呈正相关。结论 HPA和CoX-2有望成为预判恶性嗜铬细胞瘤的一种指标,并且两者均与肿瘤的血管生成有关。
Objective To investigate the expression of HPA, CoX-2 in patients with benign and malignant pheochromocytoma by detecting the expression of HPA, CoX-2 and MVD Become a predictor of malignant pheochromocytoma index, and clarify the relationship between the three. Methods 38 patients with pheochromocytoma who underwent surgery from October 1986 to August 2006 with complete clinical, pathological and follow-up data were enrolled. Among them, there were 21 cases of benign pheochromocytoma, malignant chromaffin 17 cases of cell tumor. In the malignant group, the first operation was diagnosed as pheochromocytoma followed up for 28 to 179 months. The benign group was followed up for 93 to 264 months after the first operation was diagnosed as pheochromocytoma. Another 20 cases were obtained from nephrectomy due to benign renal diseases Ipsilateral normal adrenal tissue as a control group. Immunohistochemistry was used to detect the expression of HPA, CoX-2 and MVD in benign and malignant pheochromocytoma and the control group. Results The expression of HPA was the highest in malignant group, lower in benign group and no expression in control group. The expression of HPA was significantly different between malignant group, benign group, malignant group and control group (P <0.05). CoX-2 had the highest expression in malignant group, lower expression in benign group, no expression in control group, and significant difference in the expression of CoX-2 between malignant group and benign group, malignant group and control group (P <0.05) ). MVD was highly expressed in malignant group, followed by benign group and lowest in control group. The expression of MVD in malignant group was significantly different from that in benign group and control group (P <0.05). There was a positive correlation between HPA and the expression of CoX-2 and MVD in pheochromocytoma. Conclusions HPA and CoX-2 are expected to be a predictor of malignant pheochromocytoma and both are associated with tumor angiogenesis.