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目的:观察CDX-2、Ki67、CD10和S1OOp在胆囊良恶性肿瘤中的表达及诊断价值。方法:采用免疫组化技术SP法检测28例胆囊低级别上皮内瘤变,21例高级别上皮内瘤变及19例胆囊腺癌标本中CDX-2、Ki67、CD10和S1OOp的表达。结果:1CDX-2、Ki67在胆囊低级别上皮内瘤变、高级别上皮内瘤变和胆囊腺癌中的阳性率分别为:27.14%(8/28)、47.61%(10/21)和78.95%(15/19)与21.43%(6/28)、38.09%(8/21)和73.68%(14/19);CDX-2、Ki67的阳性率随着肿瘤分化程度降低而升高,具明显的差异,各组间CDX-2和Ki67表达呈正相关。2CD10在胆囊腺癌旁良性粘膜组织中是连续阳性表达;在胆囊腺癌旁反应性增生及低级别上皮内瘤变中是不连续阳性表达;在高级别上皮内瘤变和胆囊腺癌中均为阴性表达,且其表达范围和强度随肿瘤分化程度降低而降低。3在胆囊腺癌组织中S100p蛋白的表达率为78.95%(15/19),在良性癌旁正常粘膜组织、低级别上皮内瘤变及部分高级别上皮内瘤变组织中S100p蛋白无表达,且S100p蛋白在癌组织中的表达明显高于良性及瘤变组织,差异有统计学意义,并且根据现有的资料预测S100p表达与胆囊腺癌的组织分化程度、临床分期、淋巴结转移关系密切,与患者预后相关,S100p阴性组胆囊腺癌患者与阳性组患者的生存曲线有明显差异,前者预后明显优于后者。结论:联合应用CDX-2、Ki67、CD10和S100p对于胆囊良恶性肿瘤诊断及鉴别诊断具有一定的价值,并且Ki67和S100p的阳性表达与胆囊腺癌的增殖和浸润相关,在一定程度上,有助于判断胆囊腺癌的生物学行为及其预后。
Objective: To observe the expression and diagnostic value of CDX-2, Ki67, CD10 and S1OOp in benign and malignant gallbladder tumors. Methods: The expressions of CDX-2, Ki67, CD10 and S1OOp in 28 cases of low grade intraepithelial neoplasia of gallbladder, 21 cases of high grade intraepithelial neoplasia and 19 cases of gallbladder adenocarcinoma were detected by immunohistochemical SP method. Results: The positive rates of 1CDX-2 and Ki67 in low grade intraepithelial neoplasia, high grade intraepithelial neoplasia and gallbladder adenocarcinoma were 27.14% (8/28), 47.61% (10/21) and 78.95 (15/19) and 21.43% (6/28), 38.09% (8/21) and 73.68% (14/19), respectively. The positive rates of CDX-2 and Ki67 increased with the degree of tumor differentiation Significant differences between the groups CDX-2 and Ki67 expression was positively correlated. 2CD10 in gallbladder adenocarcinoma adjacent benign mucosa is continuously positive expression in the gallbladder adenocarcinoma of parathyroid hyperplasia and low grade intraepithelial neoplasia is not continuously positive expression in high grade intraepithelial neoplasia and gallbladder adenocarcinoma Negative expression, and its expression range and intensity decreased with the degree of tumor differentiation decreased. The expression of S100p protein in gallbladder adenocarcinoma was 78.95% (15/19). There was no expression of S100p protein in normal mucosa, low grade intraepithelial neoplasia and some high grade intraepithelial neoplasia, The expression of S100p protein in cancer tissues was significantly higher than that in benign and benign tissues, and the difference was statistically significant. According to the available data, the expression of S100p was closely correlated with the histological grade, clinical stage and lymph node metastasis of gallbladder adenocarcinoma, With the prognosis of patients, S100p negative group of gallbladder adenocarcinoma patients and positive patients had significant differences in survival curves, the former prognosis was significantly better than the latter. Conclusions: The combined application of CDX-2, Ki67, CD10 and S100p is of value in the diagnosis and differential diagnosis of benign and malignant gallbladder tumors. The positive expression of Ki67 and S100p is related to the proliferation and infiltration of gallbladder adenocarcinoma. To a certain extent, To help determine the biological behavior of gallbladder adenocarcinoma and its prognosis.