眼睑恶性肿瘤组织中基底膜蛋白的分布和表达及临床意义  

Distribution and expression of basement membrane proteins in malignant eyelid tumors and its clinical significance

作　　者：林红[1] 牛膺筠[1] 周占宇[1] 刘夫玲[1] 王红云[1] 

机构地区：[1]青岛大学医学院附属医院眼科,266003

出　　处：《中华眼科杂志》2003年第3期167-171,共5页Chinese Journal of Ophthalmology

基　　金：山东省卫生厅科研基金资助项目 ( 1999CA1CKA4)

摘　　要：目的　研究眼睑恶性肿瘤组织中基底膜胶原蛋白Ⅳ (typeⅣcollagen ,ColⅣ )、层粘连蛋白 (laminin ,LN)及纤连蛋白 (fibronectin ,FN)的分布和表达 ,以探讨基底膜蛋白与恶性肿瘤组织分化、转移及预后的关系。方法　应用免疫组化链霉亲和素 生物素 过氧化物酶复合物 (streptavidinbiotincomplex ,SABC)法 ,对 85例常见眼睑恶性肿瘤石蜡标本切片的基底膜进行ColⅣ、LN及FN染色 ,并检测其蛋白的表达阳性率。其中基底细胞癌 40例 ,鳞状细胞癌 2 5例 ,睑板腺癌 2 0例。结果　正常组织及良性病变组织中基底膜比较完整 ,ColⅣ、LN及FN多分布于上皮与间质交界处及动脉内膜。而肿瘤组织中基底膜则不完整或严重缺失 ,基底细胞癌、鳞状细胞癌及睑板腺癌中ColⅣ表达阳性率分别为 6 0 %( 2 4/ 40 )、6 4%( 16 / 2 5 )、40 %( 8/ 2 0 ) ;LN表达阳性率依次为 5 8%( 2 3/ 40 )、40 %( 10 / 2 5 )、35 %( 7/ 2 0 ) ;FN表达阳性率则分别为 33%( 13/ 40 )、36 %( 9/ 2 5 )、30 %( 6 / 2 0 )。随肿瘤分化程度的降低 ,表达阳性率下降 ,高分化癌与低分化癌间差异有显著意义 ( χ2 =8 2 185 ,P <0 0 5 )。随访观察 6～ 18个月 ,肿瘤复发患者 2 4例 ,其基底膜ColⅣ、LN及FN表达阳性率均明显下降 ,与无复发肿瘤患者相比 。Objective To study the distribution and expression of type IV collagen (Col IV), laminin (LN) and fibronectin (FN) in the basement membrane of malignant eyelid tumors so as to explore the relationships between the basement membrane and the degree of differentiation, metastasis and prognosis of malignant tumors. Methods Eighty-five paraffin-embedded specimens of malignant eyelid tumors including basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and sebaceous cell carcinoma were studied to identify the Col IV, LN and FN with immunohistochemical SABC techniques. Results A continuous intact basement membrane (BM) could be identified in all of the normal tissues and benign tumor specimens. In the malignant tumor specimens, the BM was defective or absent. The positive expression rate of Col IV in BCC, SCC and sebaceous cell carcinoma was 65% (24/40), 56% (16/25) and 40% (8/20). The positive expression rate of LN was 58% (23/40), 40% (10/25) and 35.% (7/20), respectively. The positive expression rate of FN was 33% (13/40), 36% (9/25) and 30% (6/20), respectively. The positive expression rate of these extracellular matrices was correlated with the degree of differentiation of the tumor. The difference of positive rate between highly-differentiated and poorly-differentiated tumors was significant (P<0.05). In a short term follow-up (6-18 months), a statistically significant correlation (P<0.05) could be observed between tumor recurrence and BM integrity. A higher recurrence rate and early recurrence were found in patients with interrupted BM. Conclusion The absence of expression of Col IV, LN and FN was related to the invasive capacity and recurrence of the tumor. This result can be used as an index for clinical judgment of prognosis of the eyelid tumors.

关 键 词：眼睑 恶性肿瘤 肿瘤组织 基底膜蛋白Ⅳ 基因表达 层粘连蛋白 纤连蛋白类 

分 类 号：R739.7[医药卫生—肿瘤]