异黏蛋白、Bcl-2和上皮型钙黏蛋白在鼻黏膜恶性黑色素瘤中的表达及意义

摘要

Objective To study the expression and predictive value of MTDH, Bcl-2 and E-cadherin in sinonasal malignant mucosal melanoma (SNM).Methods Seventv-four fonnalin-fixed paraffin-embedded SNM specimens were subjected to immunohistochemical staining of MTDH, Bcl-2 and E-cadherin.Correlation between staining results and disease outcome was analvzed.SPSS 19.0 software was used to analyze the data.Results Positive staining of MTDH, Bcl-2 and E-cadherin was observed in 56/74 (75.7％), 18/74 (24.3％) and 21/74 (28.4％) cases, respectively.MTDH positive patients had higher metastatic rate than MTDH negative patients (67.9％ vs.33.3％ , P =0.009, OR =2.037, 95％ CI: 1.034-4.016).Negative Bcl-2 was correlated with worse overall survival time (HR =2.023, P =0.025).Expression of E-cadherin was adversely associated with expression of MTDH (r =-0.315, P =0.006).Conclusion High MTDH expression and low Bcl-2 expression suggest poor prognosis of SNM, while the predictive value of E-cadherin needs further study.%目的 探讨鼻黏膜恶性黑色素瘤中异黏蛋白(metadhein,MTDH)、Bcl-2和上皮型钙黏蛋白(E-cadherin)的表达及其临床意义.方法 免疫组化法检测74例鼻黏膜恶性黑色素瘤组织中MTDH、Bcl-2和E-cadherin的表达情况,并分析其与预后的关系.以SPSS19.0软件进行数据分析.结果 鼻黏膜恶性黑色素瘤组织中MTDH、Bcl-2和E-cadherin的阳性率分别为75.7％(56/74)、24.3％ (18/74)和28.4％ (21/74).MTDH阳性患者的肿瘤转移率(67.9％)高于MTDH阴性患者(33.3％),差异有统计学意义(P=0.009).Bcl-2阴性患者的总生存期较Bcl-2阳性患者短(HR=2.023,P=0.025).E-cadherin的表达与MTDH的表达呈负相关(r=-0.315,P=0.006).结论 鼻黏膜恶性黑色素瘤组织中 MTDH阳性、Bcl-2阴性提示预后差,而E-cadherin对预后判断的价值有待进一步研究.