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目的:研究Smad7及上皮间质转化(EMT)相关标志在胆管癌组织中的表达及与临床病理因素的关系。方法:采用免疫组化检测41例胆管癌和癌旁组织中Smad7、E-cadherin和Vimentin的表达,同时结合临床病理资料及临床预后进行分析。结果:41例胆管癌组织中Smad7、Vimentin的阳性表达率〔68.3%(28/41)、70.7%(29/41)〕及E-cadherin缺失率〔51.2%(21/41)〕明显高于相应癌旁组织〔30.0%(3/10)、30.0%(3/10)和10.0%(1/10)〕;Smad7、Vimentin和E-cadherin的表达与淋巴结转移、神经脉管浸润差异有统计学意义,P<0.05;而与性别、年龄、肿瘤部位、肿瘤类型和肿瘤分化程度等无关,P>0.05。胆管癌组织中E-cadherin的缺失及Vimentin的阳性表达与Smad7表达有相关性,P值分别为0.013和0.018;Smad7高表达者往往术后无病生存期及总生存期均较短,P值分别为0.044、0.034。结论:胆管癌在其癌变与浸润转移过程中可能发生了EMT现象,Smad7蛋白在胆管癌组织中会随进程发展而增加,可能与Smad信号通路激活,机体反馈性调节增加有关,且其有望做为一种预后指标应用于临床评估。
Objective: To investigate the expression of Smad7 and related markers of epithelial mesenchymal transition (EMT) in cholangiocarcinoma and its relationship with clinicopathological factors. Methods: Immunohistochemistry was used to detect the expression of Smad7, E-cadherin and Vimentin in 41 cases of cholangiocarcinoma and paraneoplastic tissues. The clinicopathological data and clinical prognosis were analyzed. RESULTS: The positive rates of Smad7 and Vimentin in 6 cases of cholangiocarcinoma were significantly higher than those in 68.3% (28/41) and 70.7% (29/41) and E-cadherin deficiency (51.2%, 21/41). Corresponding cancerous tissue [30.0% (3/10), 30.0% (3/10), and 10.0% (1/10)]; Smad7, Vimentin, and E-cadherin expression and lymph node metastasis, neurovascular infiltration Significance of the study, P<0.05; but not related to gender, age, tumor location, tumor type and tumor differentiation, P>0.05. The deletion of E-cadherin and the positive expression of Vimentin in cholangiocarcinoma were correlated with the expression of Smad7. The P values were 0.013 and 0.018, respectively; Smad7 high expression often had short-term disease-free survival and shorter overall survival. P value They are 0.044 and 0.034 respectively. Conclusions: EMT may occur in the process of carcinogenesis, metastasis and metastasis of cholangiocarcinoma. Smad7 protein may increase with the progression of cholangiocarcinoma, which may be related to the activation of Smad signaling pathway and increased feedback regulation of the body. For a prognostic indicator applied to clinical evaluation.