胆囊良恶性病变cdx-2和Hep表达及其临床病理意义  

Expression of cadual type homobox transcription factor-2 and hepatocyte antigen in benign and malignant lesions of gallbladder and its clinicopathological significance

作　　者：杨竹林[1] 杨乐平[1] 付汐[1] 苗雄鹰[1] 

机构地区：[1]中南大学湘雅二医院肝胆胰疾病研究室,长沙410011

出　　处：《中华肝胆外科杂志》2008年第9期647-649,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的研究胆囊腺癌、癌旁组织和慢性胆囊炎组织中尾型同源盒转录因子-2（cadual type homeobox transcription factor-2，Cdx-2）和肝细胞抗原（hepatocyte antigen，Hep）表达水平，探讨两者的临床病理意义。方法108例胆囊腺癌、46例癌旁组织和35例慢性胆囊炎手术切除标本常规石蜡包埋切片，Cdx-2和Hep染色方法为EnVision^TM免疫组化法。结果胆囊腺癌Cdx-2和Hep表达阳性率（45．5％，41．7％）明显高于癌旁组织（28．3％，23．9％，P〈0．05）和慢性胆囊炎（5．7％，5．7％，P〈0．01）。腺瘤癌变、肿块最大径〈2cm、无淋巴结转移病例Cdx-2、Hep表达阳性率明显高于低分化腺癌、肿块最大径≥2cm及淋巴结转移病例（P〈0．05或〈0．01），未侵犯周围组织器官胆囊腺癌Cdx-2表达阳性率高于侵犯周围组织器官病例（P〈0．01）；胆囊腺癌中Cdx-2与Hep表达呈高度一致性（X^2=42．27，P〈0．01）。结论Cdx-2和Hep表达可能是反映胆囊腺癌发生、进展、生物学行为及预后的重要生物学指标，胆囊黏膜肠化可能在胆囊腺癌发生中有重要临床病理价值。Objective To investigate the expression of cadual type homobox transcription factor-2 （Cdx-2） and hepatocyte antigen （Hep） in gallbladder adenocarcinoma, pericancerous tissues and chronic choleeystitis and explore its clinicopathological significance. Methods Immunohistochemical method of EnVisionTM was used to detect the expression of Cdx-2 and Hep in the routinely paraffinembedded sections of samples of gallbladder adenoearcinoma （n= 108）, pericancerous tissues （n=46） and chronic eholecystitis （n=35）. Results The positive rates of Cdx-2 and Hep were significantly higher in gallbladder adenocarcinoma （45.4%, 41. %） than in perieancerous tissues （28.3%0, 23.9%, P〈0.05） and chronic cholecystitis （5.7%, 5.7%, P〈0. 01）. The positive rates were significantly higher in the cases of adenomatous canceration, maximal diameter of mass 〈2 cm and no-metastasis of lymph node than in those of low-differentiated adenocareinoma, maximal diameter of mass ≥ 2 cm and metastasis of lymph node （P〈0. 05 or 0. 01）. The positive rate of Cd-2 was markedly higher in non-invasive cases of regional tissues than in invasive ones of regional tissues （P〈0. 01）. The high consistence was found between Cdx-2 and Hep in gallbladder adenocareinoma. Conclusion The expression of Cdx-2 and Hep might be important biological markers reflecting the carcinogenesis, progression, biological behaviors and prognosis of gallbladder adenocarcinoma. The intestinal metaplasia of gallbladder mueosa might have important clinicopathological value for carcinogenesis of gallbladder.

关 键 词：胆囊肿瘤 慢性胆囊炎 尾型同源盒转录因子2 肝细胞抗原 免疫组织化学 

分 类 号：R686[医药卫生—骨科学]