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目的检测Wnt5a基因在不同胰腺组织中的蛋白表达水平,探讨其在胰腺导管腺癌(pancreatic ductal adenocar-cinoma,PDAC)发生中的作用,为胰腺癌的早期诊疗提供新线索。方法免疫组化SP法检测Wnt5a在21灶正常胰腺导管(normal pancreatic duct,NP)、73灶胰腺上皮内瘤变(pancreatic intraepithelial neoplasia,PanIN)-1、29灶PanIN-2、16灶PanIN-3、20例胰腺导管内乳头状黏液性肿瘤(intraductal papillary mucinous neoplasm,IPMN)腺瘤(IPMN-adenoma,IPMA)、13例IPMN交界瘤(IPMN-borderline,IPMB)、19例IPMN黏液癌(IPMN-carcinoma,IPMC)及50例PDAC组织中的蛋白表达。分析Wnt5a的表达与PDAC患者临床病理特征及患者术后生存期的关系。结果随着组织病变级别升高,Wnt5a表达逐渐增强,各组Wnt5a的免疫组化评分分别为NP(0)、PanIN-1(1.90±1.192)、PanIN-2(3.03±1.322)、PanIN-3(4.88±1.455)、IPMA(1.40±0.940)、IPMB(2.62±1.502)、IPMC(3.00±1.374)、PDAC(3.11±2.635)。Wnt5a的表达与肿瘤的增殖活度、远处转移、TNM分期及患者术后生存期相关(P<0.05),Wnt5a高表达组、低表达组的中位生存期分别为15个月和21个月(P=0.015)。结论 Wnt5a参与了PDAC的发生、发展;Wnt5a表达增强是PDAC的早期事件;Wnt5a的持续表达和过度表达影响了胰腺癌的增殖、侵袭和转移过程,并预示患者预后不良。
Objective To detect the protein expression of Wnt5a in different pancreatic tissues and to explore the role of Wnt5a in the pathogenesis of pancreatic ductal adenocar-cinoma (PDAC), and provide new clues for the early diagnosis and treatment of pancreatic cancer. Methods Immunohistochemical SP method was used to detect the expression of Wnt5a in 21 normal pancreatic duct (NP), 73 pancreatin intraepithelial neoplasia (PanIN) , 20 IPMN-adenoma (IPMN), 13 IPMN-borderline (IPMB) and 19 IPMN-adenocarcinoma (IPMN- carcinoma, IPMC) and 50 cases of PDAC tissue protein expression. To analyze the relationship between Wnt5a expression and clinicopathological features and survival time of patients with PDAC. Results The expression of Wnt5a was gradually increased with the increase of histological grade. The immunohistochemical scores of Wnt5a in each group were NP (0), PanIN-1 (1.90 ± 1.192), PanIN-2 (3.03 ± 1.322), PanIN-3 (4.88 ± 1.455), IPMA (1.40 ± 0.940), IPMB (2.62 ± 1.502), IPMC (3.00 ± 1.374) and PDAC (3.11 ± 2.635). The Wnt5a expression was correlated with tumor proliferation activity, distant metastasis, TNM stage and postoperative survival (P <0.05). The median survival of Wnt5a high expression group and low expression group were 15 months and 21 Month (P = 0.015). Conclusion Wnt5a is involved in the development of PDAC. Wnt5a expression is an early event in PDAC. The sustained expression and overexpression of Wnt5a affect the proliferation, invasion and metastasis of pancreatic cancer, and indicate the poor prognosis of patients.