【摘要】 目的探讨错配修复基因hMSH2在膀胱移行细胞癌中的表达情况与肿瘤预后的关系。方法回顾性研究101例膀胱移行细胞癌患者的临床资料,采用免疫组织化学法检测错配修复基因hMSH2的表达情况,通过门诊复查、书信或电话联系方式对患者进行随访,随访12~72月,平均49月。数据分析采用SPSS 21.0统计软件,生存分析应用Kaplan-Meier法,生存率比较采用Log-rank检验,多因素分析采用Cox比例风险回归模型。结果 31例(31/101,30.7%)浸润性膀胱移行细胞癌患者中,22例hMSH2为(+)表达,9例(9/101,8.9%)完全(-)表达;70例(70/101,69.3%)浅表性膀胱移行细胞癌为(或)表达。随访结束时共56例复发,总复发率为55.45%。单因素分析发现,hMSH2低表达组平均无复发生存时间(57.20月)较高表达组(40.08月)长(P<0.05)。而膀胱移行细胞癌的TNM分期、组织学分级、淋巴结转移与肿瘤复发亦密切相关(P<0.05);Cox比例风险模型多因素分析发现,仅TNM分期及hMSH2表达情况进入COX回归模型。结论错配修复基因hMSH2表达可能是膀胱移行细胞癌独立预后指标,与肿瘤复发紧密相关,hMSH2低表达组与相同分期的高表达组比较,复发可能性小。更多还原

【Abstract】 Objective To investigate the expression patterns of hMSH2 in human bladder transitional cell carcinoma and to assess the correlation of hMSH2 protein to prognosis of the patients. Methods 101 bladder cancer patients at the First Affiliated Hospital of Fujian Medical University between 1999 to 2012were investigated retrospectively,we examined the expression patterns of hMSH2 by immunohistochemical technique,followed the patients for a median time of 49months(range 12~72months)by outpatient review,mail,or telephone. The survival rate was calculated by the Kaplan-Meier method,the log-rank test and Cox’s proportional hazards regression model using SPSS 21.0. Results Staining intensity of hMSH2 was as follows:weak staining in 22/101(21.8%),negative in 9/101(8.9%)samples,moderate or strong staining in 70/101(69.3%)samples.56/101(55.45%)was found recurrence when the follow-up ended. Univariate survival analysis showed the average recurrence-free survival of patients whose tumous with reduced and preserved for hMSH2 was 40.08 and 57.20 months,respectively,with the difference being statistically significant in univariate analysis(χ2=5.798,P=0.016),indicated that prognosis of patients with TCC was significantly corrected with pathological stage,histological grade,lymph code metastasis,as well as expression of hMSH2(P<0.05). Cox proportional hazards model multivariate survival analysis showed that TNM stage and expression of hMSH2 can be independent indicator for relapse of TCC. Conclusion hMSH2 expression may have a potential role as prognostic indicator,reduced hMSH2 expression is associated with tumors of advanced stage and grade,a favorable clinical outcome appears present when compared to those similar staged tumors with normal hMSH2 expression.更多还原