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背景与目的:腺样囊性癌(adenoidcysticcarcinoma,ACC)的临床经过常表现为治疗后复发和转移。目前尚无确切的预后判断指标。本文探讨ACC上皮细胞粘附分子钙粘蛋白(E-cadherin,E-cad)和增殖细胞核抗原(proliferatingcellnuclearantigen,PCNA)表达与预后的关系。方法:应用免疫组化染色方法对34例腺样囊性癌E-cad和PCNA的表达进行检测。结果:实体型ACC患者5年生存率明显低于筛状型和管状型患者(P<0.01)。临床分期与ACC复发转移(P<0.01)及患者术后5年生存率显著相关(P<0.01)。E-cad低表达者(占50.0%)在复发、转移和术后生存时间小于5年者多见(P<0.05)。PCNA高表达组的复发转移率明显高于低表达组(P<0.005),前者术后5年生存率则显著低于后者(P<0.005)。E-cad与PCNA在ACC中的表达显著相关(P<0.005)。结论:E-cad、PCNA的表达及临床分期可作为ACC判断预后的指标;E-cad和PCNA可能在ACC恶性进展中起协同作用。
BACKGROUND & OBJECTIVE: The clinical manifestation of adenoid cystic carcinoma (ACC) often manifests as recurrence and metastasis after treatment. There is no exact prognostic indicator. This article discusses the relationship between the expression of E-cadherin and proliferating cell nuclear antigen (PCNA) and prognosis in ACC epithelial cells. Methods: The expression of E-cad and PCNA in 34 cases of adenoid cystic carcinoma was detected by immunohistochemical staining. Results: The 5-year survival rate of patients with solid ACC was significantly lower than that of patients with both sieve and tubular type (P <0.01). The clinical stage was significantly associated with recurrence and metastasis of ACC (P <0.01) and 5-year survival rate of patients (P <0.01). The low E-cadherin expression (50.0%) was more common in recurrence, metastasis and postoperative survival time of less than 5 years (P <0.05). The recurrence and metastasis rate of PCNA high expression group was significantly higher than that of low expression group (P <0.005). The former 5 years survival rate was significantly lower than the latter (P <0.005). The expression of E-cad and PCNA in ACC was significantly correlated (P <0.005). Conclusions: The expression of E-cad and PCNA and clinical stage can be used as indicators of prognosis of ACC. E-cad and PCNA may play synergistic roles in the malignant progression of ACC.