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目的研究人类前列腺癌转移抑制基因(kangai1,KAI1)、肿瘤转移抑制基因(non-metastasis23,nm23)、E26转录因子(E26transformation-specific-1,ETS-1)、血管内皮生长因子(vascularendothelialgrowthfactor,VEGF)在鼻咽癌组织中的表达,并用CD34标记微血管测定密度,探讨它们之间的相关性及其与鼻咽癌淋巴转移和预后的关系。方法应用免疫组织化学Envision二步法检测首诊时有颈淋巴转移的鼻咽非角化性癌(non-keratinizingcarcinoma,NKC)50例、无淋巴转移的NKC30例和30例鼻咽黏膜慢性炎症组织内KAI1、nm23、ETS-1、VEGF蛋白的表达水平,并分析与NKC组织内微血管密度的关系。结果KAI1、nm23蛋白在颈淋巴转移组、无颈淋巴转移组和鼻咽黏膜慢性炎症组织中的阳性表达率依次递增(χ2=6·2,P<0·05;χ2=7·4,P<0·01);ETS-1、VEGF蛋白在3组间的阳性表达率依次递减(χ2=12·8,P<0·01;χ2=9·1,P<0·01)。80例NKC病例中KAI1、nm23蛋白阳性表达者的微血管密度(microvasculardensity,MVD)分别低于其阴性表达者(t=2·4,P<0·05;t=2·0,P<0·05);ETS-1、VEGF蛋白阳性表达者MVD分别高于其阴性表达者(t=2·6,P<0·05;t=3·6,P<0·01)。KAI1和nm23蛋白共同阳性表达较两者各自单独阳性表达时MVD降低(t=2·5,P<0·05,t=2·3,P<0·05);淋巴转移率降低(χ2=5·2,P<0·01;χ2=4·3,P<0·05);ETS-1和VEGF蛋白共同表达较两者单独表达时MVD增高(t=2·1,P<0·05;t=2·2,P<0·05),淋巴转移率增加(χ2=4·1,P<0·01;χ2=4·1,P<0·01),提示KAI1与nm23蛋白及ETS-1与VEGF蛋白的表达有相互协同的作用。KAI1与nm23蛋白及ETS-1与VEGF蛋白阳性表达成正相关关系(r=0·5,P<0·05;r=0·4,P<0·01)。NKC患者有或无颈淋巴转移与治疗后5年生存期的高低差异有统计学意义(χ2=4·4,P<0·05)。结论KAI1、nm23、ETS-1和VEGF蛋白的表达与鼻咽癌组织的微血管密度有明显相关性,与鼻咽癌的淋巴转移和预后密切相关,提示它们可以作为预测鼻咽癌颈淋巴转移及评估预后的参考指标。
Objective To investigate the expression of kangai1, KAI1, non-metastasis23 (nm23), E26 trans-formation-specific-1 (ETS-1) and vascularendothelial growth factor (VEGF) In nasopharyngeal carcinoma, and the density of CD34-labeled microvessels was measured to explore the correlation between them and its relationship with lymph node metastasis and prognosis of nasopharyngeal carcinoma. Methods Fifty cases of non-keratinizing carcinoma (NKC) with cervical lymphatic metastasis, 30 cases of NKC without lymphatic metastasis and 30 cases of chronic inflammation of nasopharyngeal mucosa The expression of KAI1, nm23, ETS-1 and VEGF proteins were analyzed by immunohistochemistry. The relationship between the expressions of KAI1, nm23, ETS-1 and VEGF was analyzed. Results The positive rates of KAI1 and nm23 protein in cervical lymph node metastasis, cervical lymph node metastasis and chronic inflammation of nasopharyngeal mucosa were increased (χ2 = 6.2, P <0.05; χ2 = 7.4, P <0.01). The positive expression rates of ETS-1 and VEGF in the three groups were decreased in turn (χ2 = 12.8, P <0.01; χ2 = 9.1, P <0.01). The microvascular density (MVD) of KAI1 and nm23 protein positive in 80 cases of NKC cases were lower than those in the negative expression (t = 2.4, P <0.05; t = 2.0, P < 05). The MVD of ETS-1 and VEGF protein were higher than those of the negative expression (t = 2.6, P <0.05; t = 3.6, P <0.01). The positive expression of KAI1 and nm23 protein were lower than those of the two positive cells (t = 2.5, P <0.05, t = 2.3, P < P <0.01, χ2 = 4.3, P <0.05). The co-expression of ETS-1 and VEGF protein was higher than that of MVD alone (t = 2.1 (Χ2 = 4.1, P <0.01; χ2 = 4.1, P <0.01), suggesting that KAI1 and nm23 protein And ETS-1 and VEGF protein expression have a synergistic effect. There was a positive correlation between KAI1, nm23 protein and ETS-1 and VEGF protein (r = 0.5, P <0.05; r = 0.4, P <0.01). There was significant difference in the 5-year survival of NKC patients with and without cervical lymph node metastasis (χ2 = 4.4, P <0.05). Conclusions The expressions of KAI1, nm23, ETS-1 and VEGF proteins are closely related to the microvessel density of nasopharyngeal carcinoma and are closely related to the lymph node metastasis and prognosis of nasopharyngeal carcinoma, suggesting that they can be used as predictors of cervical lymph node metastasis and The prognostic reference index.