目的 探讨Livin和Ki-67蛋白在胆管癌组织中的表达及两者之间的关系和临床意义.方法 采用SP法检测2002年1月至2003年12月中国医科大学附属盛京医院手术切除的55例胆管癌组织和12例慢性胆管炎组织中Livin和Ki-67蛋白的表达,并分析这两种蛋白与胆管癌临床病理特征的关系.应用Spearman等级相关分析、χ2检验和t检验对结果进行分析.结果 Livin蛋白在胆管癌标本中的阳性表达率为71%(39/55),明显高于慢性胆管炎标本的0(0/12)(χ2=20.361,P<0.01);Livin蛋白的表达受胆管癌患者的分化程度和淋巴结转移影响(χ2=4.193,4.245,P<0.05).Ki-67蛋白在胆管癌标本中的阳性表达率为96%(53/55).临床Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者Ki-67标记指数分别为22%±16%、33%±12%、43%±15%、49%±10%,Ⅱ、Ⅲ、Ⅳ期与Ⅰ期比较差异有统计学意义(t=2.307,2.871,3.957,P<0.05);有无局部淋巴结转移的患者Ki-67标记指数分别为43%±13%、34%±16%,两者比较差异有统计学意义(t=2.334,P<0.05).胆管癌组织中Livin蛋白的表达与Ki-67标记指数呈正相关(r=0.502,P<0.01).结论 Livin蛋白在胆管癌的发生、发展中起重要作用,并且与胆管癌增殖活性相关,两者结合可作为胆管癌恶性程度和判断预后的标准.%Objective To investigate the relationship between Livin and Ki-67 proteins, and the expres-sion and clinical significance of Livin and Ki-67 proteins in cholangiocarcinoma. Methods Fifty-five samples of cholangiocarcinoma tissue were collected in Shengjing Hospital from January 2002 to December 2003. The expres-sion of Livin and Ki-67 proteins in the 55 samples of cholangiocarcinoma tissue and 12 samples of chronic cholan-gitis tissue were detected by immunohistochemical assay. The relationship between the expression of Livin and Ki-67 proteins and the clinicopathological parameters of cholangiocarcinoma was analyzed. The results were analyzed by Spearman rank correlation coefficient, chi-square test and t test. Results The positive expression rate of Livin protein in cholangiocarcinoma was 71% (39/55), which was significantly higher than 0 (0/12)in chronic cholan-girls tissue (χ2=20.361, P<0.01). The expression of Livin protein was influenced by the differentiation of cholangiocarcinoma and the lymph node metastasis (χ2=4.193, 4.245, P <0.05). The positive expression rate of Ki-67 protein was 96% (53/55) in cholangiocarcinoma. The label index of Ki-67 in patients in clinical stage Ⅰ,Ⅱ,Ⅲ,Ⅳ,were 22%±16%, 33%±12%, 43%±15%, and 49%±10%, respectively. There was signifi-cant difference in the label index of Ki-67 between patients in clinical stage Ⅰ and those in clinical stages Ⅱ, Ⅲ,Ⅳ(t=2.307, 2.871, 3.957, P<0.05). The label index of Ki-67 was 43%±13 % in patients with local lymph node metastasis, and 34%±16% in patients without local lymph node metastasis, with statistical difference between the 2 groups (t=2.334, P<0.05). The expression of Livin protein in cholangiocarcinoma was positively correlated with the label index of Ki-67 (r=0.502, P<0.01). Conclusions Livin protein plays an important role in the pathogenesis and development of eholangiocarcinoma, and it also has correlation with the proliferating activity of cholangiocarcinoma cells. Combined detection of the expression of Livin and Ki-67 proteins may be helpful in judging the malignancy of cholangiocarcinoma and determining the prognosis of patients.
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