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目的:探讨XIAP、SMAC在胆管癌组织中表达与两者在胆管癌患者血清中水平以及两者的临床意义。方法:用免疫组化方法检测54例胆管癌患者在胆管癌组织及其癌旁组织中XIAP与SMAC的表达,用ELISA法检测25例胆管癌患者与15例健康人血清中XIAP与SMAC的水平。分析两者表达与患者临床病理因素的关系,以及患者手术前后两者水平的变化。结果:胆管癌组织中XIAP表达阳性率明显高于癌旁组织(81.45%vs.30.00%,P<0.05),而SMAC表达阳性率明显低于癌旁组织(38.89%vs.80.00%,P<0.05)。XIAP表达与胆管癌病理分型及是否伴有淋巴结转移有关,而SMAC表达与胆管癌TNM分期、是否伴有淋巴结转移有关(均P<0.05);在胆管癌组织中XIAP、SMAC表达呈负相关(r=-0.327,P<0.05)。胆管癌患者术前血清XIAP水平明显高于健康对照人群,而血清SMAC水平明显低于健康对照人群(均P<0.05);术后两者水平术后趋向正常。XIAP与SMAC在胆管癌患者癌组织中的表达与其在血清中的水平具有一致性(r=0.381,P=0.025;r=0.623,P=0.000)。结论:胆管癌组织中XIAP表达升高,而SMAC表达降低;两者联合检测对胆管癌早期诊断、治疗效果及预后的判断有一定意义。
Objective: To investigate the expression of XIAP, SMAC in cholangiocarcinoma and their clinical significance in serum of cholangiocarcinoma patients and their clinical significance. Methods: The expressions of XIAP and SMAC in 54 cases of cholangiocarcinoma and its adjacent tissues were detected by immunohistochemistry. The levels of XIAP and SMAC in 25 cases of cholangiocarcinoma and 15 cases of healthy people were detected by ELISA . Analysis of the relationship between the expression of the two and clinicopathological factors, as well as changes in patients before and after the level of both. Results: The positive rate of XIAP expression in cholangiocarcinoma tissues was significantly higher than that in paracancer tissues (81.45% vs. 30.00%, P <0.05), but the positive rate of SMAC expression in cholangiocarcinoma tissues was significantly lower than that in paracancer tissues (38.89% vs.80.00%, P < 0.05). The expression of XIAP was correlated with the pathological type of cholangiocarcinoma and lymph node metastasis, while the expression of SMAC was correlated with TNM stage and lymph node metastasis (all P <0.05). There was a negative correlation between XIAP and SMAC expression in cholangiocarcinoma (r = -0.327, P <0.05). Preoperative serum XIAP level in patients with cholangiocarcinoma was significantly higher than that in healthy controls, while serum SMAC levels were significantly lower than those in healthy controls (all P <0.05). Both postoperative levels tended to be normal. The expression of XIAP and SMAC in cancer tissues of cholangiocarcinoma was consistent with that in serum (r = 0.381, P = 0.025; r = 0.623, P = 0.000). Conclusions: The expression of XIAP in cholangiocarcinoma is increased, while the expression of SMAC is decreased. The combined detection of both of them has some significance for the early diagnosis, treatment and prognosis of cholangiocarcinoma.