【摘要】 目的观察Midine(MK)在原发性胆囊癌中的表达情况,并探讨其与原发性胆囊癌临床病理指标之间的关系。方法选择1995年1月～2003年6月胆囊癌53例、腹腔转移灶12例、淋巴结转移灶12例和正常胆囊20例、胆囊腺瘤14例,均采用免疫组织化学方法检测MK在其中的表达情况;结合53例胆囊癌患者临床病理资料分析MK表达指数与组织学类型、分化程度、临床分期、局部淋巴结转移、肝脏浸润及腹腔广泛转移的关系。结果正常胆囊、胆囊腺瘤与原发性胆囊癌的MK表达标记指数(LI)中位数分别为0%、17%(5%,29%)、72%(41%,98%),三者比较差异有高度统计学意义(P<0.01);胆囊淋巴结转移灶及腹腔转移灶Midkine表达LI的中位数分别为90%(76%,100%)、88%(65%,100%),二者Midkine表达LI与原发灶比较,差异有统计学意义(P<0.05);结合临床病理资料统计分析发现,胆囊癌的分化程度越低,Midkine表达LI越高,差异有统计学意义(P<0.05);Midkine在晚期胆囊癌中表达LI水平高于早中期,差异有统计学意义(P<0.05);Midkine在伴有肝脏浸润灶中表达LI水平高于不伴肝脏浸润,差异有统计学意义(P<0.05);Midkine在伴有广泛腹腔转移中表达LI水平高于不伴腹腔广泛转移,差异有统计学意义(P<0.05)。结论 Midkine可作为胆囊癌新的标记物;Midkine表达与胆囊癌发生、发展有关,对胆囊癌的临床分期、浸润转移的估计和病人预后的判断有一定意义。更多还原

【Abstract】 Objective To observe the expression of Midline in gallbladder tumor tissues and to investigate the relevance between the Midine and clinical pathological index of primary gallbladder carcinoma.Methods 53 cases of human primary gallbladder carcinoma,12 cases of peritoneal metastases,12 cases of lymph node metastases,20 cases of normal gallbladder and 14 cases of gallbladder adenoma from January 1995 to June 2003 were selected,immunohistochemistry was used to detect the expression of Midine;the relevance between the labeling index(LI) of Midine and 53 cases of clinical pathologic data of primary gallbladder carcinoma,such as histological type,differentiated degree,clinical stages,local lymph node metastasis,liver infiltration and celiac widespread metastasis were analyzed.Results LI of Midine in normal gallbladder,gallbladder adenoma and primary gallbladder carcinoma were 0%,17%(5%,29%),72%(41%,98%),the differences were statistically significant(P < 0.01);LI of Midine in lymph node metastases and peritoneal metastases were 90%(76%,100%) and 88%(65%,100%),compared with the primary lesion,the differences were statistically significant(P < 0.05);combine with the clinicopathologic data,the differentiated degree of primary gallbladder carcinoma was lower,the LI of Midine was higher,the differences were statistically significant(P < 0.05);the LI of Midine in advanced primary gallbladder carcinoma was higher than that in early and medium-term,the differences were statistically significant(P < 0.05);the LI of Midine in primary gallbladder carcinoma combined with liver infiltration was higher than that in non-liver infiltration,the differences were statistically significant(P < 0.05);the LI of Midine in primary gallbladder carcinoma combined with celiac widespread metastasis was higher than that in non-celiac widespread metastasis,the differences were statistically significant(P < 0.05).Conclusion It is possible to make Midkine as a new marker of gallbladder carcinoma.The expression of Midkine has the positive relation with the occurrence and development;it is significant to estimate the clinical stages and metastasis,it also has certain significance to judge the prognosis.更多还原