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目的 :探讨磷脂酰肌醇蛋白聚糖3(glypican-3,GPC3)在卵巢透明细胞腺癌中的表达及临床意义。方法 :采用免疫组织化学方法分别检测83例卵巢癌组织(透明细胞腺癌45例、浆液性癌20例、黏液性癌18例)、20例浆液性囊腺瘤及20例正常卵巢组织中GPC3蛋白的表达情况,实时荧光定量PCR法检测38例卵巢癌组织(透明细胞腺癌20例、浆液性癌10例、黏液性癌8例)、5例浆液性囊腺瘤和5例正常卵巢组织中m RNA的表达情况,并分析GPC3与卵巢透明细胞腺癌临床病理学参数及预后的相关性。结果:1卵巢透明细胞腺癌中GPC3蛋白阳性表达率和m RNA表达量(82.2%;1.326 1±0.493 6)均明显高于浆液性癌(20%;0.426 5±0.029 4)、黏液性癌(5%;0.265 2±0.103 9)、浆液性囊腺瘤(0%;0.141 3±0.011 3)、正常卵巢组织(0%;0.291 4±0.048 1),差异有统计学意义(P均<0.01);2GPC3蛋白阳性表达率及GPC3 m RNA表达量与卵巢透明细胞腺癌的临床分期有相关性,Ⅲ~Ⅳ期患者中的表达(100%;1.808 1±0.265 7)显著高于Ⅰ~Ⅱ期患者(71.4%;1.045 8±0.403 6)(P值<0.01);3卵巢透明细胞腺癌铂类药物耐药患者GPC3蛋白阳性表达率及m RNA表达量(100%;1.808 1±0.265 7)均高于铂类药物敏感型患者(70.3%;0.991 8±0.330 3)(P<0.05);4GPC3蛋白阳性表达率与卵巢透明细胞腺癌患者的预后相关,预后差的患者中阳性率及表达量高,差异有统计学意义(P<0.05),Kaplan-Meier单因素生存分析亦显示GPC3蛋白为影响预后的因素(P=0.048);5卵巢透明细胞腺癌中GPC3蛋白阳性表达率和m RNA表达量与患者的淋巴结转移和远处器官转移无相关性(P>0.05)。结论 :GPC3在病理鉴别诊断中有重要意义,GPC3与卵巢透明细胞腺癌患者的临床分期和铂类耐药相关,提示其可能在卵巢透明细胞腺癌的发生发展起重要作用,有望成为卵巢透明细胞腺癌的预后指标和潜在治疗靶标。
Objective: To investigate the expression and clinical significance of glypican-3 (GPC3) in ovarian clear cell adenocarcinoma. Methods: Immunohistochemistry was used to detect 83 cases of ovarian cancer tissues (45 clear cell adenocarcinomas, 20 serous carcinomas, and 18 mucinous carcinomas), 20 serous cystadenomas, and 20 normal ovarian tissues. Protein expression, real-time fluorescence quantitative PCR detection of 38 cases of ovarian cancer tissue (clear cell adenocarcinoma in 20 cases, 10 cases of serous carcinoma, 8 cases of mucinous carcinoma), 5 cases of serous cystadenoma and 5 cases of normal ovarian tissue The expression of m RNA was analyzed, and the correlation between GPC3 and clinicopathological parameters and prognosis of clear cell adenocarcinoma of the ovary was analyzed. RESULTS: 1 The positive expression rate of GPC3 protein and the expression level of m RNA in ovarian clear cell adenocarcinoma (82.2%; 1.326 1±0.493 6) were significantly higher than those of serous carcinoma (20%; 0.426 5±0.029 4) and mucinous carcinoma. (5%; 0.265 2 ± 0.103 9), serous cystadenoma (0%; 0.141 3 ± 0.011 3), normal ovarian tissue (0%; 0.291 4 ± 0.048 1), the difference was statistically significant (P < 0.01); 2GPC3 protein positive expression rate and GPC3 m RNA expression level were correlated with the clinical stage of ovarian clear cell adenocarcinoma, and the expression in patients with stage III to IV (100%; 1.808 1±0.265 7) was significantly higher than that of I~ Stage II patients (71.4%; 1.045 8±0.403 6) (P<0.01); 3 GPC3 protein positive rate and m RNA expression level in platinum-resistant ovarian adenocarcinoma patients (100%; 1.808 1±0.265) 7) Both of them were higher than platinum-sensitive patients (70.3%; 0.991 8±0.330 3) (P<0.05). The positive rate of 4GPC3 protein was correlated with the prognosis of patients with ovarian clear cell adenocarcinoma, and the positive rate was poor in patients with poor prognosis. And the expression level was high, and the difference was statistically significant (P<0.05). Kaplan-Meier univariate survival analysis also showed that GPC3 protein was a factor that affected prognosis (P=0.048); 5 GPC3 protein positive expression in ovarian clear cell adenocarcinoma And m RNA expression in patients with lymph node metastasis and distant metastasis no correlation (P> 0.05). Conclusion: GPC3 has important significance in pathological differential diagnosis. GPC3 is associated with clinical stage and platinum resistance in patients with clear cell adenocarcinoma of the ovary, suggesting that it may play an important role in the development of ovarian clear cell adenocarcinoma and may become an ovarian transparent Prognostic indicators and potential therapeutic targets for cell adenocarcinoma.