【摘要】 目的 检测连接黏附分子A(junctionaladhesionmolecule-A,JAM-A)在膀胱尿路上皮癌(bladder urothelial carcinoma,BUC)中的表达状况，探讨JAM-A蛋白表达与尿路上皮癌发生发展以及临床病理指标的关系及意义。方法 采用免疫组织化学SP法和Western blot方法检测了尿路上皮癌和癌旁组织中JAM-A表达状况，探讨JAM-A在各组间表达的差异及与临床病理特征之间的关系。结果 免疫组织化学SP法结果显示20例癌旁组织中JAM-A表达只有3例(15%)阳性，而肿瘤组织中JAM-A表达阳性率为100%(119/119),JAM-A蛋白表达显著高于癌旁组织(P<0.001);Western blot结果 JAM-A蛋白表达在尿路上皮癌组织表达量(4.23±0.68)显著高于癌旁组织(2.18±0.57)，差异有高度统计学意义(P<0.001)，相关性分析结果显示JAM-A蛋白表达与尿路上皮癌浸润、淋巴结转移相关；JAM-A蛋白高表达与尿路上皮癌浸润(P<0.05)、淋巴结转移(P<0.001)呈正相关，而与慢性炎症、性别、年龄均无相关性。ROC结果显示，JAM-A在尿路上皮癌病理诊断中AUC值为0.878，灵敏度为66.4%、特异度为85%。结论 尿路上皮癌中JAM-A高表达对病理诊断有一定的价值；与JAM-A蛋白低表达相比较，JAM-A蛋白高表达更容易发生浸润和淋巴结转移，表明JAM-A蛋白高表达参与了尿路上皮癌的发生发展过程，可能对临床不良预后有一定的参考意义。更多还原

【Abstract】 Objective To detect the expression of junctional adhesion molecule-A(JAM-A) in bladder urothelial carcinoma(BUC), and to identify its clinical significance in the progression and clinicopathological parameters of BUC. Methods Expression levels of JAM-A in BUC and paracancerous specimens were detected by immunohistochemistry(SP method) and Western blot. Its correlation with clinicopathologic parameters was analyzed.Results Immunohistochemistry showed only 3 positive cases(15%) of JAM-A expression in 20 paracancerous specimens, but 100%(119/119) positivity for BUC. Protein level of JAM-A was significantly higher in the BUC specimens than paracancerous specimens(P<0.001).Western blot showed a significantly higher protein level of JAM-A in the BUC specimens than paracancerous specimens([4.23±0.68] VS [2.18±0.57],P<0.001).The correlation analysis results showed that the protein expression of JAM-A was significantly associated with BUC infiltration(P<0.05) and lymph node metastasis(P<0.001) in a positive correlation.It was not correlated with chronic inflammation,gender,and age.The receiver operating characteristic(ROC) results showed that the area under the curve(AUC) of JAM-A in the pathological diagnosis of BUC was 0.878,with a sensitivity of 66.4% and a specificity of 85%.Conclusion The high expression of JAM-A in BUC has certain value in pathological diagnosis. BUC with higher JAM-A level is more prone to infiltration and lymph node metastasis than the low level of JAM-A. It suggests that high-level JAM-A participates in the progression of BUC,indicating a poor prognosis.更多还原