Shi Jing-Sen, Zhou Lian-Suo, Han Yue, Zhu Ai-Jun, Sun Xue-Jun, Yang Yi-Jun
Department of Hepatobiliary Surgery, First Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
Hepatobiliary Pancreat Dis Int. 2004 Aug;3(3):448-52.
Some reports have confirmed that occurrence and development of tumor are related with lots of oncogene, anti-oncogene and cytokine. This study was to detect the expression of TNFmRNA, tumor necrosis factor (TNF) and TNF receptor (TNFR) in the gallbladder mucosa which developed from hyperplasia, dysplasia to carcinoma, and to further discuss the pathogenecity of gallbladder carcinoma.
The expression of TNFmRNA, TNF and TNFR was detected by in situ hybridization and immunohistochemistry on the surgical specimens of hyperplasia, dysplasia and carcinoma of the gallbladder.
The percentage of positive cells expressed TNFmRNA in the gallbladder mucosa was 0%, 20%, and 90%, respectively in hyperplasia, dysplasia and carcinoma (P<0.05). The percentage of positive mononuclear cells (MNCs) expressed TNFmRNA in hyperplasia, dysplasia and carcinoma of gallbladder tissues was 15%, 85%, and 90%, respectively (P<0.05). The number of positive MNC high-power field (Hpf) was 4.85+/-1.50, 6.00+/-2.71, and 9.33+/-3.07, respectively (P<0.05). The number of carcinoma cells and MNCs expressed by TNFmRNA per high-power field was increased with the increase of tumor stage. The number of carcinoma cells/Hpf in stages I-III and IV-V was 9.13+/-4.39 and 7.13+/-2.53 (P<0.05), and that of MNC/Hpf was 14.80+/-4.02 and 11.10+/-2.23 (P<0.01). The number of carcinoma cells and MNCs expressed by TNFmRNA per Hpf was increased with the increase of tumor size. In tumors of more than 2 cm or less than 2 cm in diameter, the number of positive carcinoma cells/Hpf was 14.00+/-4.20 and 8.83+/-4.96, respectively (P<0.05), but that of MNC/Hpf was 10.50+/-2.54 and 7.00+/-2.83 (P<0.05). The pattern of TNF protein expression was similar to that of TNFmRNA, whereas TNF protein expression was more frequent and extensive than TNFmRNA expression. TNFR was expressed in endothelial cells and MNCs of carcinoma, and was negative in mucosal epithelial cells and tumor cells. A positive linear correlation in TNFmRNA expression was observed between tumor cells and MNCs (r=0.687, P<0.01), a correlation in TNFmRNA and TNF protein expression of tumor cells (r=0.847, P<0.001), and a correlation in TNFmRNA and TNF protein expression of MNC in tumor tissue (r=0.643, P<0.01).
TNFmRNA and TNF protein expression is increased during the development of gallbladder mucosa from hyperplasia, dysplasia to carcinoma, and is increased with tumor stage. This finding suggests that TNF is involved in the pathogenesis of gallbladder carcinoma induced by gallstones and the TNF expression in cancer cells may serve as a marker for tumor stage.
一些报道证实肿瘤的发生发展与多种癌基因、抑癌基因及细胞因子有关。本研究旨在检测从增生、发育异常到癌变的胆囊黏膜中肿瘤坏死因子信使核糖核酸(TNFmRNA)、肿瘤坏死因子(TNF)及肿瘤坏死因子受体(TNFR)的表达情况,并进一步探讨胆囊癌的发病机制。
采用原位杂交和免疫组化方法检测胆囊增生、发育异常及癌变手术标本中TNFmRNA、TNF及TNFR的表达。
胆囊黏膜中TNFmRNA阳性细胞百分比在增生、发育异常及癌变时分别为0%、20%和90%(P<0.05)。胆囊组织增生、发育异常及癌变时TNFmRNA阳性单核细胞(MNCs)百分比分别为15%、85%和90%(P<0.05)。MNCs高倍视野(Hpf)阳性数分别为4.85±1.50、6.00±2.71和9.33±3.07(P<0.05)。每高倍视野TNFmRNA表达的癌细胞和MNCs数量随肿瘤分期增加而增多。Ⅰ-Ⅲ期和Ⅳ-Ⅴ期癌细胞/Hpf数量分别为9.13±4.39和7.13±2.53(P<0.05),MNC/Hpf数量分别为14.80±4.02和11.10±2.23(P<0.01)。每Hpf TNFmRNA表达的癌细胞和MNCs数量随肿瘤大小增加而增多。直径大于2 cm或小于2 cm的肿瘤中,阳性癌细胞/Hpf数量分别为14.00±4.20和8.83±4.96(P<0.05),但MNC/Hpf数量分别为10.50±2.54和7.00±2.83(P<0.05)。TNF蛋白表达模式与TNFmRNA相似,但TNF蛋白表达比TNFmRNA表达更频繁、更广泛。TNFR在癌组织的内皮细胞和MNCs中表达,在黏膜上皮细胞和肿瘤细胞中为阴性。肿瘤细胞与MNCs的TNFmRNA表达呈正线性相关(r=0.687,P<0.01),肿瘤细胞的TNFmRNA与TNF蛋白表达呈相关性(r=0.847,P<0.001),肿瘤组织中MNC的TNFmRNA与TNF蛋白表达呈相关性(r=0.643,P<0.01)。
在胆囊黏膜从增生、发育异常到癌变的过程中,TNFmRNA和TNF蛋白表达增加,并随肿瘤分期增加。这一发现提示TNF参与胆结石诱导的胆囊癌发病机制,癌细胞中的TNF表达可能作为肿瘤分期的标志物。