摘要
目的探讨肝内胆管癌(ICC)患者肿瘤组织中期因子(MK)蛋白表达水平与肿瘤临床病理特征、患者生存期之间的关系。方法收集2013年12月至2017年12月在南京鼓楼医院行手术治疗的ICC患者的临床资料及手术切除的肿瘤样本35例,应用免疫组化方法检测癌组织中MK蛋白的表达水平,并分析其与临床病理特征的关联性;手术后对患者进行随访,以因ICC死亡为终点事件,采用Kaplan-Meier生存曲线进行MK高、低表达者的生存分析。结果 35例ICC患者中,免疫组化结果显示,17例MK蛋白低表达(弱阳性),18例高表达(强阳性)。在T分期T1+T2期、有淋巴结转移、低分化程度者中,MK蛋白高表达阳性率较T分期T3+T4期、无淋巴结转移、高分化程度者显著升高(P值分别为0. 044、0. 028、0. 019)。本次随访截止于2018年3月,失访8例,完成随访27例;死亡20例,存活7例。MK蛋白低表达者的中位生存期(23个月)明显长于MK蛋白高表达者(7个月),差异有统计学意义(P=0. 020)。结论 MK蛋白拟可作为ICC的肿瘤标记物,提示其恶性程度及患者预后。
Objective To investigate the associations of the expression of midkine（MK） protein with clinicopathological features and outcomes of the patients with intrahepatic cholangiocarcinoma（ICC）. Methods The clinical data and surgically resected tumor samples of 35 ICC patients who underwent surgical treatment in Nanjing Drum Tower Hospital from December 2013 to December 2017 were collected. The expression of MK protein in cancer tissues was detected using immunohistochemistry,and its correlation with clinicopathological features was analyzed. The patients were followed up after surgery,and the end point was death from ICC. The survival of patients with high and low MK expression was analyzed by Kaplan-Meier survival curve. Results Immunohistochemical results showed the low expression（weak positive） of MK in17 cases and high expression（strong positive） in 18 cases. The positive rate of MK protein expression was significantly higher in patients of T1 and T2 stage and with lymph node metastasis and poor differentiation than that in patients of T3 and T4 stage and with non-lymph node metastasis and high differentiation（P = 0. 044,P = 0. 028,P = 0. 019,respectively）.The follow up ended on March 2018,and 8 cases were lost to follow-up. Out of 27 cases with follow-up,20 cases died and 7 cases survived. The median survival time（23 months） of patients with low MK protein expression was significantly longer than that（7 months） of patients with high MK protein expression（P = 0. 020）. Conclusion MK protein may be used as a tumor marker for ICC and can predict the degree of malignancy and prognosis of ICC patients.
作者
钱涛
马江辉
夏雪峰
陶亮
李强
QIAN Tao;MA Jiang-hui;XIA Xue-feng;TAO Liang;LI Qiang(Department of General Surgery,Drum Tower Clinical Medical College of Nanjing Medical University,Nanjing,Jiangsu 210008,China)
出处
《中国临床研究》
CAS
2018年第10期1361-1363,共3页
Chinese Journal of Clinical Research
基金
国家自然科学基金青年基金(81500482)
关键词
肝内胆管癌
中期因子
临床病理特征
预后
Intrahepatic cholangiocarcinoma
Midkine
Clinieopathological feature
Prognosis
