OBJECTIVE: To investigate the expression of sperm-associated antigen 9 (SPAG9) in bladder transitional cell carcinoma (BTCC), and analyze its clinical significance. METHODS: The expression of SPAG9 protein was assessed by immunohistochemistry in bladder sections of 98 patients with BTCC and 30 normal bladders. The relationship between SPAG9 and grade of pathology, clinical state and the 2-year recurrence rate were analyzed. RESULTS: No obvious expression of SPAG9 was observed in normal bladder samples. However BTCC samples showed high expression ratio of SPAG9, reaching 75.5%(74/98). Furthermore, the expression level of SPAG9 increased with tumor stage and grade. SPAG9 positive expression rates showed significant difference between histological grades G1, G2 and G3 (P<0.05); and clinical stages Ta and T1 group (P<0.05). Besides, non-muscle-invasive bladder cancer patients with positive SPAG9 expression showed high incidence of 2-year recurrence. CONCLUSION: SPAG9 is high expressed in BTCC, making it a useful tumor marker and a possible indicator for estimating the invasiveness and recurrence of BTCC. Blocking SPAG9 expression and its functions may become targeted therapy of bladder cancer treatment.%目的:探讨精子相关抗原9 (sperm-associated antigen 9,SPAG9)在膀胱移行细胞癌(bladder transitional cell carcinoma,BTCC)中的表达并分析其临床意义.方法:选取经临床病理诊断的BTCC标本98例,正常膀胱组织30例,应用免疫组化染色方法检测SPAG9在BTCC中的表达和分布情况,分析其与肿瘤的临床分期、病理分级及2年复发率的关系.结果:SPAG9在正常膀胱组织中为阴性表达,而在BTCC组中的阳性表达率为75.5％ (74/98),并且随着肿瘤分期和分级的升高SPAG9蛋白的表达增加,SPAG9阳性表达率在病理分级G1、G2与G3级之间的差异有统计学意义(P＜0.05)；在临床分期Ta与T1组间的差异有统计学意义(P＜0.05)；SPAG9蛋白表达阳性的非肌层浸润性膀胱癌患者,其2年复发率显著高于阴性表达者(P＜0.05).结论:SPAG9蛋白在BTCC中呈高表达状态,可成为BTCC有意义的肿瘤标志物,并有可能作为判断BTCC侵袭力、监测复发的重要指标.阻断SPAG9表达有望成为膀胱癌靶向治疗的新靶点.
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