层粘连蛋白332α3链的表达模式与胰腺癌的关系

摘要

目的检测胰腺癌组织中层粘连蛋白332α3链（Laminin 332α3，LNα3）的阳性表达水平，探讨其表达模式与胰腺癌的关系。方法应用免疫组织化学方法（Envision法）检测65例胰腺癌标本中LNα3蛋白的表达情况，以癌旁正常组织作为对照，并分析胰腺癌组织中LNα3蛋白不同表达模式[单一胞质表达（SCT）与胞质/间质共表达（CMT）]与胰腺癌临床病理特征及预后的关系。结果65例胰腺癌组织中LNα3蛋白的阳性表达率100%，显著高于癌旁正常组织（1.6%），差异有统计学意义（P＜0.01）。其中SCT 42例，CMT 23例。LNα3链的不同表达模式与胰腺癌肝转移、血管浸润、胆管浸润均有关（P＜0.05或0.01），胞质/间质的共表达预示胰腺癌患者较高的肝转移率、血管浸润及胆管浸润的风险。肝转移、临床分期、十二指肠浸润和肿瘤位置与胰腺癌患者的生存期明显相关（P＜0.05或0.01），肿瘤位置和临床分期是预测生存期的独立因素（P＜0.05），肿瘤位于胰体尾或临床分期越高的预后差，肝转移、浆膜侵犯、十二指肠浸润均不能作为独立的预测因素（均P＞0.05）。结论 LNα3的表达与胰腺癌的发生、侵袭、转移密切相关，尤其是胞质/间质的共表达可作为判断胰腺癌肝转移、血管浸润、胆管浸润的重要参考指标。但是影响胰腺癌预后的因素较多，需要结合各种因素综合判断。%Objective To investigate the protein expression level of laminin 332α3 chain (LNα3) and the correlation of its expression pattern with pancreatic carcinoma. Methods The expression level and pattern of LNα3 were detected by immuno-histochemistry with EnVision method in 65 pancreatic carcinoma specimens and adjacent normal tissues. The correlation of LNα3 expression and its pattern with clinicopathologic features and prognosis was analyzed. Results The positive rate of LNα3 was significantly higher in 65 pancreatic carcinoma specimens (100.0%) than that in adjacent normal tissues (1.6%, P<0.01). The single cytoplasmic expression type (SCT) was presented in 42 cases and the cytoplasmic/mesenchymal coexpression type(CMT) was in 23 cases. The different expression patterns of LNα3 were associated with hepatic metastasis and vascular in-vasion and bile duct invasion (P<0.05 or 0.01) and the CMT type indicated a higher risk. The overal survival of patients was sig-nificantly correlated with hepatic metastasis, T stages, duodenal invasion and tumor location(P<0.05 or 0.01). Tumor location and T stage were independent predictors of overal survival (P<0.05). The tumor location and higher clinical stages were correlated with poor prognosis, while hepatic metastasis and invasion to serosa and duodenal invasion were not the independent predictors (P>0.05). Conclusion The expression of LNα3 is closely correlated with pancreatic carcinoma and its invasion and metastasis, especial y the CMT type can be used as an important prognostic index.