不同组织结构类型中神经母细胞瘤中CD82与LRP、MDR1、TopoⅡα的表达及意义  

The expressions of CD82, LRP, MDR1 and Topo Ⅱα in different histological patterns of neuroblastoma in children

作　　者：顾松[1] 徐敏[1] 洪莉[1] 张忠德[1] 殷敏智[1] 陈其民[1] 吴晔明[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心外科,200127

出　　处：《中华小儿外科杂志》2009年第3期143-146,共4页Chinese Journal of Pediatric Surgery

基　　金：国家自然科学基金（30600751）;上海交通大学医学院优秀青年教师基金

摘　　要：目的探讨肿瘤转移抑制因子CD82与耐药相关蛋白LRP、多药耐药MDR1、拓扑异构酶TopoⅡα在不同组织结构类型的神经母细胞瘤（组织结构良好型，FH型；组织结构不良型，UFH型）中的表达及其意义。方法收集2001年5月以来近6年上海儿童医学中心保存的儿童神经母细胞瘤石蜡标本33例（其中UFH神经母细胞瘤10例，平均肿瘤分期3期；FH神经母细胞瘤23例，平均肿瘤分期2．57期；男17例，女16例；年龄范围1个月～15岁，平均年龄33．1个月；随访时间21～87个月，平均随访时间45．5个月）。利用组织芯片的高通量、低误差、经济省时等优点，将二组标本制作成组织芯片，再行免疫组织化学SP法检测CD82、LRP、MDR1、TopoⅡα在神经母细胞瘤中的表达。采用SAS统计软件对结果进行统计学处理，两样本比较采用Wilcoxon秩和检验。结果相对于FH型神经母细胞瘤，UFH型神经母细胞瘤中的CD82表达明显下降，差异有统计学意义（P〈0．05）；而LRP、MDR1、TopoⅡα的表达显著增强，二组之间差异有统计学意义（P〈0．05）。UFH型失随访1例，平均随访时间34．5个月，随访时存活率66．6%；FH型失随访2例，平均随访时间49．5个月，随访时存活率80．9％，两组之间差异有统计学意义（P〈0．05）。结论CD82基因的失活在肿瘤转移的潜在性中起着重要作用，UFH型神经母细胞瘤中CD82的低表达表明了UFH型肿瘤具有较强的远处转移能力，而LRP、MDR1、TopoⅡα的表达显著增强，表明了UFH型神经母细胞瘤细胞对化疗药物耐药性更为显著。FH型预后相对较好，可能与患儿不同的年龄、肿瘤分期、较少的转移潜力、肿瘤细胞的较低化疗药物耐药性均有关。Objective To investigate the expressions and significance of CD82, LRP, MDR1 and Topo Ⅱα in different histological types of neuroblastorna （favorable histology, FH and unfavorable histology, UFH）. Methods The paraffin specimens of 33 cases （ male 17, female 16） of neuroblastoma （FH 23 cases, Stage 3; UFH 10 cases, Stage 2. 57） were collected after May. 2001. The age ranged from 1 month to 15 years, （mean 33. 1 months） The follow-up period was 21- 87 month （average 45.5 mon） Tissue microarray was applied for the advantages of high-throughput, low error, economic and time-saving . The expressions of CD82, LRP, MDR1 and Topo Ⅱα in neuroblastoma were detected by SP immunohistochemical staining. SAS statistical software was applied. The outcomes of these two samples were compared by Wilcoxon rank sum test. Results Compared to the FH neuro- blastoma, UFH neuroblastoma in CD82 expression was significantly decreased （P〈0. 05）. But LRP, MDR1 and Topo Ⅱα showed significantly higher expression between the FH and UFH group. （P〈 0. 05）. The average follow-up period was 34. 5 months in UFH with a survival rate of 66. 6%, and the mean follow-up of FH was 49. 5 months with a survival rate of 80. 9% （P〈0. 05）. Conclusions CD82 has played an important role in potentially inactivation of tumor metastasis . The low expression of CD82 in UFH neuroblastoma indicates a strong distal metastastic tendency. The obvious expressions of LRP, MDR1, Topo Ⅱα demonstrate the UFH with more chemotherapeutic drug resistance. The favorable prognosis of FH may be related to the age, tumor stage, less potential of metastasis and chemotherapy resistance.

关 键 词：神经母细胞瘤 免疫组织化学 临床分析 耐药性 

分 类 号：R686[医药卫生—骨科学]