胆囊良恶性病变组织中HMGA2和CD9表达及意义  

Expression of HMGA2 and CD9 and their clinicopathological significances in benign and malignant lesions of gallbladder

作　　者：吕芳[1] 杨竹林[1] 杨乐平[1] 熊力[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：《临床与实验病理学杂志》2011年第2期121-125,共5页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的研究胆囊良恶性病变组织中HMGA2和CD9表达水平及其临床病理意义。方法 108例胆囊腺癌、46例癌旁组织、15例腺瘤和35例慢性胆囊炎手术切除标本常规制作石蜡包埋切片,HMGA2和CD9染色方法为EnVision免疫组化法。结果胆囊腺癌HMGA2表达阳性率明显高于癌旁组织(χ2=16.13,P<0.01)、腺瘤性息肉(χ2=8.19,P<0.01)和慢性胆囊炎(χ2=21.41,P<0.01);胆囊腺癌CD9表达阳性率明显低于癌旁组织(χ2=8.76,P<0.01)、腺瘤性息肉(χ2=3.96,P<0.05)和慢性胆囊炎(χ2=14.31,P<0.01);HMGA2表达阳性和(或)CD9表达阴性的良性病例的胆囊上皮均呈中至重度不典型增生。高分化、肿块最大径<2 cm、无淋巴结转移、未侵犯周围组织的病例HMGA2表达阳性率明显低于低分化、肿块最大径≥2 cm、淋巴结转移和侵犯周围组织的病例(P<0.05或P<0.01);高分化腺癌、肿块最大径<2 cm、无淋巴结转移和未侵犯周围组织的病例CD9表达阳性率明显高于低分化腺癌、肿块最大径≥2 cm、淋巴结转移和侵犯周围组织病例(P<0.05或P<0.01)。经Kaplan-Meier生存分析发现HMGA2表达阳性病例术后生存期明显低于阴性表达病例(P=0.020),但CD9表达阳性病例术后生存期明显高于阴性表达病例(P=0.019);Cox多变量回归分析显示HMGA2阳性表达和(或)CD9表达阴性是反映胆囊腺癌预后不良的一个重要指标。结论 HMGA2和CD9表达与胆囊腺癌发生、临床生物学行为及预后有密切关系。Purpose To study on the expression levels of HMGA2 and CD9 and their clinicopathological significances in benign and malignatnt lesions of the gallbladder.Methods EnVisiom immunohistochemical method for determining the expression of HMGA2 and CD9 was used in routinely paraffin-embedded sections of surgical resected specimens from gallbladder adenocarcinoma（n=108）,peritumoral tissues（n=46）,adenomatous polyp（n=15）,and chronic cholecystitis（n=35）.Results The positive rate of HMGA2 expression was significantly higher in gallbladder adenocarcinoma than that in peritumoral tissues（χ2=16.13,P0.01）,adenomatous polyp（χ2=8.19,P0.01） and chronic cholecystitis（χ2=21.41,P0.01）.The positive rate of CD9 expression was significantly lower in gallbladder adenocarcinoma than that in peritumoral tissues（χ2=8.76,P0.01）,adenomatous polyp（χ2=3.96,P0.05） and chronic cholecystitis（χ2=14.31,P0.01）.The positive cases of HMGA2 and/or negative ones of CD9 in the benign lesions showed moderately-or severe-atypical hyperplasia of gallbladder epithelia.The positive rates of HMGA2 were significanctly lower in the cases of well-differentiated adenocarcinoma,with maximal diameter of mass 2 cm,no-metastasis of lymph node,and no-invasiveness of regional tissues than those in the ones of poorly-differentiated adenocaarcinoma,with maximal diameter of mass 2 cm,metastasis of lymph node,and invasiveness of regional tissues in gallbladder adenocarcinoma（P0.05 or P0.01）.The positive rates of CD9 were significanctly higher in the cases of well-differentiated adenocarcinoma,with maximal diameter of mass 2 cm,no-metastasis of lymph node,and no-invasiveness of regional tissues than those in the ones of poorly-differentiated adenocaarcinoma,with maximal diameter of mass 2 cm,metastasis of lymph node,and invasiveness of regional tissues in gallbladder adenocarcinoma（P0.05 or P0.01）.Unitivariate Kaplan-Meier analysis showed that increased expression of HMGA2（P=0.020） or decreased expression of CD9（P=0.

关 键 词：胆囊肿瘤 胆囊息肉 慢性胆囊炎 高迁移率族蛋白A2 迁移相关蛋白-1/CD9 免疫组织化学 

分 类 号：R735.8[医药卫生—肿瘤]