膜联蛋白A1和A2在胆囊良恶性病变组织中的表达水平及其与胆囊腺癌临床病理特征的关系  

Expression of annexin A1 （ ANXA1 ） and A2 （ANXA2） and its significance in benign and malignant lesions of gallbladder

作　　者：杨乐平[1] 杨竹林[1] 谭兴国[1] 苗雄鹰[1] 

机构地区：[1]中南大学湘雅二医院肝胆疾病研究室,长沙410011

出　　处：《中华肿瘤杂志》2010年第8期595-599,共5页Chinese Journal of Oncology

摘　　要：目的 研究膜联蛋白A1（ANXA1）和膜联蛋白A2（ANXA2）在胆囊腺癌、癌旁组织、胆囊腺瘤性息肉和慢性胆囊炎组织中的表达水平及其与胆囊腺癌临床病理特征之间的关系.方法 选取108例胆囊腺癌、46例癌旁组织、15例胆囊腺瘤性息肉和35例慢性胆囊炎手术切除标本,常规制作石蜡包埋切片.采用免疫组织化学EnVsionTM法检测各组织中ANXA1和ANXA2的表达水平.结果 ANXA1和ANXA2在胆囊腺癌组织中的阳性表达率分别为59.3%和56.5%,其评分值分别为3.2±0.9和3.4±0.8;在癌旁组织中的阳性表达率分别为34.8%和30.4%,其评分值分别为1.1±0.8和1.0±0.8;在胆囊腺瘤性息肉组织中的阳性表达率分别为26.7%和26.7%,其评分值分别为0.9±0.7和0.9±0.8;在慢性胆囊炎组织中的阳性表达率分别为17.1%和20.0%,其评分值分别为0.7±0.9和0.8±0.8.胆囊腺癌组织中ANXA1和ANXA2的阳性表达率及其评分均高于癌旁组织、胆囊腺瘤性息肉组织和慢性胆囊炎组织（均P＜0.05）.ANXA1和（或）ANXA2阳性表达的癌旁组织、胆囊腺瘤性息肉和慢性胆囊炎上皮均呈轻至重度不典型增生.高分化腺癌、肿瘤最大径＜2 cm、淋巴结未转移及未侵犯周围组织的胆囊腺癌患者ANXA1和ANXA2的阳性表达率,均明显低于中或低分化腺癌、肿瘤最大径≥2 cm、有淋巴结转移及侵犯周围组织者（均P＜0.05）.在胆囊腺癌组织中,ANXA1和ANXA2的表达呈高度一致性（x2=67.84,P＜0.01）,其评分值之间呈高度密切正相关（r=0.78,P＜0.01）.Kaplan-Meier单因素分析及Cox多因素回归分析结果均显示,ANXA1和ANXA2的表达均不是影响胆囊腺癌预后的重要因素.结论 ANXA1和ANXA2的表达水平可能是反映胆囊腺癌发生、发展及生物学行为的重要生物学指标,但并不能预测胆囊腺癌患者的预后.Objective To study the expression levels of ANXA1 and ANXA2 and elucidate their clinicopathological significance in adenocarcinoma, peritumoral tissues, adenomatous polyp and chronic cholecystitis of gallbladder. Methods EnVisonTM immunohistochemical staining was used to detect the expression of ANXA1 and ANXA2 in paraffin-embedded tissue sections from resected specimens of adenocarcinoma （n = 108 ）, peritumoral tissue （ n = 46 ）, adenomatous polyp （ n = 15 ） and chronic cholecystitis （n = 35 ）. Results The positive rates and scores of ANXA1 and ANXA2 were significantly higher in adenocarcinoma （59.3%, 56. 5%; 3.2 ± 0. 9,3. 4 ± 0. 8） than those in peritumoral tissues （34. 8%,1.1 ±0.8, P〈0.01; 30.4%, 1.0 ±0.8, P〈0.01）, adenomatous polyp （26.7%, 0.9 ±0.7, P〈0.05or P〈0.01; 26.7%, 0.9±0.8, P〈0.05 or P〈0.01） and chronic cholecystitis （17.1%, 0.7 ＋0.9,P〈0.01; 20.0%, 0. 8 ＋0. 8, P 〈0.01 ）. The benign lesions with positive ANXA1 and/or ANXA2expression showed mild to severe atypical hyperplasia of the gallbladder epithelium. The positive rates of ANXA1 and/or ANXA2 were significantly lower in the well-differntiated adenocarcinoma, in a maximal diameter of 〈 2 cm, with no metastasis to lymph nodes and no invasion to surrounding tissues than those in the moderately or poorly-differentiated adenocarcinoma, in a maximal diameter of ≥2 cm, with metastasis to lymph nodes and invasion in surrounding tissues （ P 〈 0. 05 or P 〈 0.01 ）. A high consistence was found between the expression levels of ANXA1 and ANXA2 （x2 = 67.84, P 〈 0.01 ）, and a close positive correlation between the scores of ANXA1 and ANXA2 （ r = 0. 78, P 〈 0.01 ） in gallbladder adenocarcinoma.Kaplan-Meier analysis and multivariate Cox regression analysis showed that ANXA1 or ANXA2 was not an independent prognostic predictor in gallbladder adenocarcinoma. Conclusion The expression levels of ANXA1 and/or ANXA2 may be important biological markers in the carcinogenesis, progression and b

关 键 词：胆囊肿瘤 膜联蛋白A1 膜联蛋白A2 免疫组织化学 

分 类 号：R686[医药卫生—骨科学]