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目的:观察性激素受体(雄激素受体和雌激素β受体,AR和ERβ)在膀胱癌中的表达,通过它们与临床病理特征和术后复发预后的相关分析来探讨性激素受体的临床意义与价值。方法:采用免疫组织化学SP法检测AR和ERβ蛋白在64例膀胱尿路上皮癌的表达。显微镜下随机选取5个400×高倍视野,每个视野计数100个癌细胞中的阳性细胞数,通过计算染色阳性的细胞率来评估受体蛋白的表达情况。结果:两种性激素受体蛋白均阳性定位于细胞核中。AR阳性表达率为26.6%,ERβ阳性率为81.2%。AR和ERβ的阳性表达率在男女性别方面均无统计学差别(P=0.1982,0.0669)。随着膀胱癌病理分级升高,AR和ERβ的阳性表达率均增高(P=0.0182,0.0360)。同时,AR和ERβ的表达与患病年龄,膀胱内肿瘤数目,肿瘤大小,肿瘤的临床分期均无统计学相关性(P均>0.05)。术后随访患者时间为2-81月,生存分析显示:AR与肿瘤的复发间隔期和5年复发率相关(P=0.0442)。ERβ则与肿瘤患者的总生存期相关(P=0.0001)。阳性表达AR的患者,复发间隔时间增长,5年复发率较低;ERβ阳性患者总生存期较长。结论:性激素受体AR和ERβ阳性表达于临床膀胱癌组织中,并且均与膀胱癌的分化密切相关。这提示AR和ERβ可能在膀胱癌的发生发展中起一定作用。同时,两种蛋白还能作为评估膀胱癌复发预后的预测指标。
OBJECTIVE: To observe the expression of sex hormone receptors (androgen receptor and estrogen receptor, AR and ERβ) in bladder cancer and to explore the clinical significance of sex hormone receptor by their correlation with clinicopathological features and postoperative recurrence and prognosis Meaning and value. Methods: Immunohistochemical SP method was used to detect the expression of AR and ERβ in 64 cases of bladder urothelial carcinoma. Under the microscope, five 400 × high power fields were randomly selected, and the number of positive cells in 100 cancer cells was counted in each field. The expression of receptor protein was evaluated by counting the positive staining cells. RESULTS: Both sex hormone receptor proteins were positively localized in the nucleus. The positive rate of AR was 26.6% and the positive rate of ERβ was 81.2%. The positive rates of AR and ERβ were not statistically different between men and women (P = 0.1982, 0.0669). With the pathological grading of bladder cancer, the positive expression rates of AR and ERβ were higher (P = 0.0182,0.0360). Meanwhile, the expression of AR and ERβ was not related to the age at onset, number of intravesical tumors, tumor size and clinical stage (P> 0.05). Postoperative follow-up of patients was performed from January to August. Survival analysis showed that the relapse interval of AR was associated with 5-year recurrence (P = 0.0442). ERβ correlated with the overall survival of tumor patients (P = 0.0001). The positive expression of AR in patients with relapse interval increased, 5-year recurrence rate is low; ERβ-positive patients with a longer overall survival. Conclusion: The positive expression of sex hormone receptors AR and ERβ in clinical bladder cancer tissues are closely related to the differentiation of bladder cancer. This suggests that AR and ERβ may play a role in the development of bladder cancer. At the same time, the two proteins can be used as a predictor of the prognosis of bladder cancer recurrence.