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目的探讨Smad4和转化生长因子β1(TGFβ1)及Ⅱ型受体(TGFβRⅡ)在胆管癌组织中的表达及与胆管癌生物学行为及预后的关系。方法应用免疫组织化学SP及SABC法检测47例胆管癌及癌旁正常胆管组织中的Smad4和TGFβ1、TβRⅡ的表达,并分析比较与胆管癌患者的临床分期、病理分级等的关系。结果47例胆管癌组织中TGFβ1阳性表达36例(76.6%),较癌旁正常胆管组织高,而Smad4和TGFβRⅡ表达减低,分别为14(29.8%)、28(59.6%)例(P<0.05)。TGFβ1表达与胆管癌临床分期及淋巴结转移和肝转移相关(均P<0.05),与组织学分级无关(P>0.05);TGFβRⅡ表达与胆管癌临床分期相关(P<0.05),与组织学分级及淋巴结转移和肝转移无关(均P>0.05);Smad4表达与胆管癌组织学分级、临床分期及是否淋巴结和肝转移相关(均P<0.05)。结论Smad4、TGFβRⅡ和TGFβ1的表达与胆管癌组织学分级、临床分期及是否淋巴结转移、肝转移有一定的相关性。联合检测三者有助于判断胆管癌的恶性程度和预后。
Objective To investigate the expression of Smad4, transforming growth factor β1 (TGFβ1) and type Ⅱ receptor (TGFβRⅡ) in cholangiocarcinoma and its relationship with the biological behavior and prognosis of cholangiocarcinoma. Methods The expressions of Smad4, TGFβ1 and TβRII in 47 cases of cholangiocarcinoma and adjacent normal bile duct tissue were detected by SP immunohistochemistry and SABC method. The relationship between the expression of Smad4, TGFβ1 and TβRⅡ in clinical cholangiocarcinoma was analyzed. Results The positive expression of TGFβ1 in 47 cases of cholangiocarcinoma was significantly higher than that in the adjacent normal bile duct tissues (36.6% vs 14.6%, P <0.05), while the expression of Smad4 and TGFβRII was decreased ). The expression of TGFβ1 was correlated with clinical stage, lymph node metastasis and liver metastasis (all P <0.05), but not with histological grade (P> 0.05). The expression of TGFβRⅡ was correlated with the clinical stage of cholangiocarcinoma (P <0.05) And lymph node metastasis and liver metastasis (all P> 0.05). The expression of Smad4 was correlated with histological grade, clinical stage and lymph node and liver metastasis (all P <0.05). Conclusion The expressions of Smad4, TGFβRⅡ and TGFβ1 are correlated with the histological grade, clinical stage and lymph node metastasis and liver metastasis of cholangiocarcinoma. Joint detection of the three will help determine the degree of malignancy and prognosis of cholangiocarcinoma.