去整合素-金属蛋白酶17过度表达对肝外胆管癌手术患者的预后价值  

The prognostic value of overexpression of ADAM17 in patients with extrahepatic cholangiocarcinoma after resection

作　　者：谭勇[1] 邱宝安 孟宇宏 祝建勇 夏念信 杨英祥 刘鹏 周阳 

机构地区：[1]南方医科大学第三临床医学院,广州510515 [2]解放军海军总医院肝胆外科,北京 [3]解放军海军总医院病理科,北京

出　　处：《中华肝胆外科杂志》2015年第10期674-677,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：首都市民健康培育基金（Z141100002114015）

摘　　要：目的探讨去整合素一金属蛋白酶17（ADAM17）表达与肝外胆管癌临床病理特征的联系，评估ADAM17过表达是否与肝外胆管癌患者的预后相关。方法使用免疫组化染色检测78例肝外胆管癌患者ADAM17表达情况，分析肝外胆管癌组织ADAM17表达水平与患者临床病理参数以及手术预后的关系。结果肝外胆管癌组织ADAM17表达水平显著高于癌旁组织（P〈0．05），ADAM17高表达与患者临床病理参数如肿瘤大小、T分期、淋巴结转移和血管侵犯显著相关（P〈0．05）。单因素分析显示ADAM17高表达与手术预后差显著相关（P〈0．05），ADAM17高表达与肝外胆管癌根治性切除术后总体生存呈负相关（P〈0．05）。多因素COX分析结果显示，ADAM17高表达是肝外胆管癌术后总体生存的独立预后因素。结论ADAM17过度表达可能参与了肝外胆管癌的侵袭和进展，且与肝外胆管癌患者手术预后差相关。Objective To investigate the relationship between the expression of ADAM17 and the clinicopathological parameters of extrahepatie cholangiocarcinoma （ECC）, and to correlate the overexpres- sion of ADAM17 with prognoses of patients with ECC. Method The expressions of ADAM17 in 78 patients with ECC from the Navy General Hospital were detected by immunohistoehemieal staining and the relation- ships between the ADAM17 expression and the clinicopathological parameters, and the prognosis of patients with ECC after resection were analyzed. Results The expression of ADAM17 was higher in cancer tissues than their adjacent tissues （ P 〈 0. 05 ）. A high expression of ADAM17 was significantly correlated with tumour size, T classification, lymph node metastasis, and vascular invasion （P 〈 0.05）. Univariate analysis revealed a high expression of ADAM17 was significantly related with poor prognosis after resection （P 〈 0.05 ） , a high expression of ADAM17 was inversely associated with overall survival for patients with ECC after curative resection （P 〈 0.05）. Multivariate COX analysis indicated a high expression of ADAM17 was an independent prognostic factor of overall survival for patients with ECC after resection. Conclusion Overexpression of ADAM17 was correlated with invasion, progression of ECC and with a poor prognosis in patients with ECC after resection.

关 键 词：肝外胆管癌 去整合素一金属蛋白酶17 高表达 临床病理参数 预后 

分 类 号：R735.8[医药卫生—肿瘤]