Objective To study the significance of metastasis associated genes nm23,p53 and S100A4 in the development of conjunctival melanoma metastasis.Methods Conjunctival melanoma tissue specimens were collected from 42 cases of conjunctival melanoma patients in Henan Eye Hospital from July 2015 to November 2016,meanwhile 30 cases of conjunctival nevus tissue samples served as control group under the informed consent.The expressions of nm23,p53 and S100A4 were detected in conjunctival melanoma group and control group by Western blot and immunohistochemical method.The relationship between the clinical and pathological features of nm23,p53 and S100A4 with conjunctival melanoma patients with lymph nodes metastasis were analyzed.Results Western blot assay showed that the expression level of nm23 in conjunctival melanoma group was lower than that in the control group,with a significant difference between them (P＜0.05);the expression level of p53 and S100A4 in conjunctival melanoma group was significantly higher than those in the control group (both at P＜0.05).Immunohistochemistry showed that nm23 and S100A4 appeared claybank in cytoplasm,while p53 appeared red in cell nucleus.The positive rate of nm23 protein expression in conjunctival melanoma group was significantly lower than that in the control group (14.3％ vs.53.3％,P＜0.05).The positive rate of p53 expression in conjunctival melanoma group was significantly higher than that in the control group (54.8％ vs.6.7％,P＜0.05).The positive rate of S100A4 expression in the conjunctival melanoma group was significantly higher than that in the control group (59.5％ vs.6.7％,P＜0.05).There were no difference in nm23,p53 and S100A4 protein expression positive rate between various gender groups,various age groups and various ulcer groups (all at P＞0.05).There were siginificant differences in nm23,p53 and S100A4 protein expression positive rate between various sclera invasion groups and various distant metastasis groups (all at P＜0.05).Conclusions Expression of nm23,p53 and S100A4 may play an important role in the invasion and metastasis of conjunctival melanoma,which may be the main reference index for the diagnosis and treatment.%目的 探讨肿瘤转移相关基因nm23、p53和S100A4在结膜黑色素瘤转移和进展中的作用.方法 结膜黑色素瘤组织样本来源于2015年7月至2016年11月在河南省立眼科医院及郑州人民医院诊治的42例结膜黑色素瘤患者,另取30例结膜色素痣组织标本作为对照组.采用Western blot法与免疫组织化学法分别检测结膜黑色素瘤组及对照组nm23、p53和S100A4的表达,并分析nm23、p53和S100A4与结膜黑色素瘤患者淋巴结转移等临床病理特征的关系.结果 Western blot结果显示,结膜黑色素瘤组的nm23表达水平明显低于结膜色素痣组,差异有统计学意义(P＜0.05);结膜黑色素瘤组p53和S100A4的表达水平明显高于对照组,差异均有统计学意义(均P＜0.05).免疫组织化学染色可见,nm23、S100A4染色定位于细胞质,呈棕黄色;p53定位于细胞核,呈红色.免疫组织化学结果显示,结膜黑色素瘤组nm23蛋白表达阳性率为14.3％,明显低于对照组的53.3％,差异有统计学意义(P＜0.05).结膜黑色素瘤组p53、S100A4表达阳性率分别为54.8％和59.5％,明显高于结膜色素痣组的6.7％和6.7％,差异均有统计学意义(均P＜0.05).不同性别、不同年龄、有无溃疡组间nm23、p53和S100A4蛋白表达阳性率比较,差异均无统计学意义(均P＞0.05).巩膜导管是否侵犯、远处转移是否发生组间nm23、P53和S100A4蛋白表达阳性率比较,差异均有统计学意义(均P＜0.05).结论 nm23、p53和S100A4的表达可能在结膜黑色素瘤的侵袭及转移中发挥着重要作用,可能成为结膜黑色素瘤诊治的重要参考指标.
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