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目的观察趋化因子CXCL12及其特异性受体CXCR4在原发性十二指肠腺癌组织中的表达,探讨两者在该病的发生、浸润和转移中的作用。方法应用免疫组织化学方法检测78例原发性十二指肠腺癌组织、癌旁组织以及正常十二指肠黏膜组织中CXCL12和CXCR4的表达情况,分析两者表达与患者临床病理参数和术后生存率之间的关系。结果 CXCL12和CXCR4在肿瘤组织、癌旁组织以及正常十二指肠黏膜组织中均有表达,肿瘤组织中的阳性表达率明显高于癌旁组织,癌旁组织又明显高于正常十二指肠黏膜组织(P均<0.05)。两者在肿瘤组织中的表达水平与肿瘤细胞分化程度、区域淋巴结转移情况、远处转移情况和TNM分期均有关(P均<0.05)。CXCL12和CXCR4阳性表达的患者其3年和5年生存率均明显低于阴性表达者(P均<0.05)。单因素分析还提示肿瘤细胞分化程度低、肿瘤浸润肠壁较深、区域淋巴结转移、远处转移和TNM分期较晚也为原发性十二指肠腺癌患者术后预后不良的因素,Cox多因素分析则认为其中CXCL12或CXCR4阳性、肿瘤细胞分化程度低、区域淋巴结转移和TNM分期较晚为独立影响因素。结论原发性十二指肠腺癌组织中CXCL12和CXCR4的过表达与其生物学行为及预后密切相关,检测两者表达对预测该病的转移及预后判断有一定的价值。
Objective To observe the expression of chemokine CXCL12 and its specific receptor CXCR4 in primary duodenal adenocarcinoma and to explore the role of CXCL12 in the pathogenesis, invasion and metastasis of this disease. Methods The expressions of CXCL12 and CXCR4 in 78 cases of primary duodenal adenocarcinoma, adjacent non-cancerous tissues and normal duodenal mucosa were detected by immunohistochemistry. The expressions of CXCL12 and CXCR4 were analyzed with the clinicopathological parameters and technique Post survival rate of the relationship between. Results The expression of CXCL12 and CXCR4 in tumor tissue, paracancer tissue and normal duodenal mucosa were both significantly higher than that in paracancerous tissues and paracancer tissues, which were significantly higher than that in normal duodenum Mucosal tissues (all P <0.05). The expression levels of these two proteins in tumor tissues were correlated with tumor cell differentiation, regional lymph node metastasis, distant metastasis and TNM staging (all P <0.05). The 3-year and 5-year survival rates of both CXCL12 and CXCR4-positive patients were significantly lower than those of the negative ones (all P <0.05). Univariate analysis also indicated that the low degree of differentiation of tumor cells, deeper tumor infiltration of the intestinal wall, regional lymph node metastasis, distant metastasis and TNM staging late postoperative prognosis of primary duodenal adenocarcinoma of poor prognosis factors Cox In the multivariate analysis, CXCL12 or CXCR4 positive, low degree of tumor cell differentiation, regional lymph node metastasis and late TNM stage were independent influencing factors. Conclusions The overexpression of CXCL12 and CXCR4 in primary duodenal adenocarcinoma is closely related to their biological behavior and prognosis. To detect the expression of CXCL12 and CXCR4 may be of value in predicting the metastasis and prognosis of this disease.