高迁移率族蛋白 A1与垂体腺瘤侵袭及复发的相关性  

Correlations of the expression of HMGA1 protein with the aggressiveness and recurrence of pituitary ade-noma

作　　者：欧慧婷[1] 阎德文[1] 刘明铭[1] 李剑[2] 尹为华[2] 左敏 尹卫[2] 

机构地区：[1]深圳市第二人民医院内分泌科,深圳518000 [2]北京大学深圳医院病理科,北京大学深圳医院神经外科 [3]深圳市人民医院病理科

出　　处：《中华内分泌外科杂志》2014年第6期486-490,共5页Chinese Journal of Endocrine Surgery

摘　　要：目的：观察高迁移率族蛋白A1（the high mobility group A1，HMGA1）在垂体腺瘤的表达特征，探讨其与腺瘤侵袭及复发的关系。方法采用免疫组化方法，分析HMGA1蛋白在侵袭与非侵袭性腺瘤、复发与非复发性腺瘤表达率的差异及相关性。结果52例腺瘤HMGA1均呈阳性表达，信号定位细胞核分布较均匀。 HMGA1蛋白的表达率，在功能性与非功能性腺瘤间（ P＝0.79），不同免疫表型腺瘤间（P＝0.28），表达差异无统计学意义。侵袭与非侵袭性腺瘤（（0.50±0.20） vs（0.24±0.17），P ＝0.000）），复发与非复发性腺瘤（（0.60±0.20）vs（0.24±0.18），P＝0.000）），微腺瘤、大腺瘤与巨大腺瘤（（0.18±±0.17）vs（0.40±0.23）vs（0.52±0.20），P＝0.03）），HardyⅠ级、Ⅱ级与Ⅲ-Ⅳ级腺瘤（（0.18±0.17） vs（0.30±0.20） vs（0.50±0.20），P＝0.003））间，差异有统计学意义。 HMGA1预测腺瘤复发的ROC曲线下面积为0.918（＞0.90）。当HMGA1表达率49.2％时，对腺瘤复发预测的特异性达90.5％，敏感度71.4％。结论 HMGA1表达水平与腺瘤的体积、侵袭性及复发显著相关，其预测腺瘤复发风险的准确度较高；HMGA1表达特点有利于病理医师对其准确与可重复性判读。Objective To observe the expression of high mobility group A 1（HMGA1）protein in pituitary adenoma（PA）and explore its relationship with the aggressiveness and recurrence of PA .Methods The labeling index（LI）of HMGA1, detected by immunohistochemistry staining , was compared between aggressive and non-aggressive PA, recurrent and non-recurrent PA.Results The expression of HMGA1 were observed in all 52 cases of PA and homogenously distributed in nuclear of tumor cells .The LI of HMGA1 showed no significant difference between functioning and nonfunctioning PA （P=0.79）, as well as among different immunophenotypical variants of PA（P=0.28）.The expression of HMGA1 was significantly higher in the aggressive PA than in the nonaggres-sive PA（0.50 ±0.20 vs 0.24 ±0.17, P=0.000）.Patients with a recurrent PA had a higher value of HMGA 1 than patients with a non-recurrent PA（0.60 ±0.20 vs 0.24 ±0.18, P=0.000）.The expression of HMGA1 in-creased stepwise with the tumor size, as the highest was present in macro-sized PA（0.52 ±0.20）and the lowest was in micro-sized PA（0.18 ±0.17）.A similar trend was found in Hardy＇s grade I（0.18 ±0.17）,II（0.30 ± 0.20）and III-IV（0.50 ±0.20）（P=0.003）.The area under the ROC curve was 0.918（〉0.90）.When the LI reached 49.2%, the predicting specificity was 90.5%and the sensitivity was 71.4%.Conclusions The LI of HMGA1 has a positive correlation with the tumor size , aggressiveness and recurrence of PA and also has a valuable predicting efficacy for PA recurrence .The characteristics of HMGA 1 in PA can help pathologists make reproducible evaluation on prognosis of PA .

关 键 词：垂体腺瘤 侵袭 复发 高迁移率族蛋白A1 

分 类 号：R736.4[医药卫生—肿瘤]