抑癌基因FHIT表达缺失与胆囊癌病理特征及预后的关系  

Loss expression of FHIT closely correlated with clinicopathological features and post-resectional survival of gallbladder carcinoma

作　　者：陈卫东[1] 马勇[1] 赵华[1] 李铁钢[1] 

机构地区：[1]中南大学湘雅二医院普通外科,湖南长沙410011

出　　处：《中国医师杂志》2008年第9期1159-1161,共3页Journal of Chinese Physician

摘　　要：目的观察胆囊癌中FHIT的表达改变与病理特征及预后的关系，探讨FHIT在胆囊癌恶性起源中的作用，评价FHIT表达缺失在胆囊癌根治术后预后判断中的作用。方法收集临床资料完整的石蜡包埋胆囊癌标本43例及慢性胆囊炎标本43例，免疫组化SP法测定FHIT的表达，对所有43例胆囊癌进行为期2年的随访。结果胆囊癌组织FHIT表达低于癌旁组织和慢性胆囊炎的表达（χ^2=31．74，P=0．000），且FHIT表达随三组间组织恶性程度的升高而下降，其表达阳性率分别为83．72％、48．84％、23．26％。胆囊癌男性女性FHIT的表达阳性率相当（χ^2=0．03，P：0．866），60岁以上者和60岁以下者表达阳性率相当（χ^2=0．22，P=0．637）。胆囊癌临床分期更晚期者、组织学分型恶性程度更高者，其FHIT的表达更低（χ^2=4．47，P=0．035；χ^2=8．33，P=0．015）。并且，FHIT的表达和胆囊癌的临床分期（rs=-0．56，P=0．031）、组织学分型（rs=-0．68，P=0．014）均呈负相关。log-rank检验显示：FHIT阳性表达的患者术后生存要明显优于FHIT阴性表达者（χ^2=4．11，P=0．042）。COX模型显示：患者的年龄、临床分期、组织学分期及FHIT的表达缺失是影响预后的独立因素。FHIT阴性表达者预后与阳性表达者相对危险度RR为2．89，95％可信区间为[2．46—3．32]。结论FHIT的表达缺失与胆囊癌病理特征有关，其表达缺失在胆囊癌的恶性发生发展中可能起到一定作用；FHIT的表达缺失是判断胆囊癌预后的一个的独立因素。Objective We aimed to explore the expression of FHIT and investigate its correlation with clinicopathological teatures and prognosis of gallbladder carcinoma. Method Immunohistoehemical detection of FHIT was performed on samples from 43 gallbladder carcinoma and 43 cholecystitis, and 2 years follow up was performed. Result FHIT protein was overexpressed in cholecystitis（ χ^2 = 31.74, P =0. 000） . The overexpression was significantly related to differentiation and Nevin staging of gallbladder carcinoma（x2 = 4.47, P = 0.035;χ^2=8.33,P =0.015）;（rs= -0.56, P =0.031; rs = -0.68, P =0.014）. Log-rank test showed that overexpressionofFHIT had a good prognosis （X^2 = 4. 11, P = 0. 042）. Cox analysis showed that expression of FHIT was an independent prognostic marker for post- resectional survival of gallbladder carcinoma（ RR = 2. 89, 95 % CI [ 2. 46 - 3.32 ] ）. Conclusion Loss expression of FHIT closely correlated with clinicopathological features of gallbladder carcinoma. The expression of FHIT was an independent prognostic marker for post-reseetional survival of gallbladder carcinoma.

关 键 词：基因 肿瘤抑制 组氨酸 胆囊肿瘤 预后 

分 类 号：R735.8[医药卫生—肿瘤] R734.202[医药卫生—临床医学]