Pizzi Sara, Porzionato Andrea, Pasquali Claudio, Guidolin Diego, Sperti Cosino, Fogar Paola, Macchi Veronica, De Caro Raffaele, Pedrazzoli Sergio, Parenti Anna
Department of Medical Diagnostic Sciences and Special Therapies, University of Padova, Padova, Italy.
Histol Histopathol. 2009 Feb;24(2):175-85. doi: 10.14670/HH-24.175.
The purposes of this study were to evaluate the prognostic significance of Glut-1 expression in patients with pancreatic ductal adenocarcinoma, and to analyse its expression in pancreatic intraepithelial neoplasias (PanIN) and non invasive intraductal papillary mucinous neoplasms (IPMN). Glut-1 expression was studied by immunohistochemistry in 60 pancreatic ductal adenocarcinomas and scored on a 4-point scale (1: <25%; 2: 25-50%; 3: 50-75%; 4: >75%). Relationships between Glut-1 score, histological grade and MIB-1 score were evaluated by the Spearman rank correlation test. Significant correlations were found between Glut-1 expression and histological grade (P<0.001) and MIB-1 score (P<0.01). Significant prognostic factors by univariate analysis were stage (P<0.0001), histological grade (P<0.001) and Glut-1 expression (P<0.005). Independent prognostic factors after multivariate analysis were stage (P<0.001) and Glut-1 expression (P<0.05), stratified as <50% and >50%. The correlation of Glut-1 score with histological grade and MIB-1 score indicated a higher glucose uptake in poorly differentiated and highly proliferative pancreatic cancer cells. Glut-1 immunohistochemical expression provides a useful prognostic factor in pancreatic ductal adenocarcinoma. Glut-1 expression was not found in PanINs 1 but in 27.8% and 43.8% of PanINs 2 and 3, and was not found in IPMNs with low- and moderate-grade dysplasia but in 60% of IPMNs with high-grade dysplasia, indicating Glut-1 involvement in a relatively early phase of pancreatic carcinogenesis.
本研究的目的是评估葡萄糖转运蛋白1（Glut-1）表达在胰腺导管腺癌患者中的预后意义，并分析其在胰腺上皮内瘤变（PanIN）和非侵袭性导管内乳头状黏液性肿瘤（IPMN）中的表达情况。采用免疫组织化学方法对60例胰腺导管腺癌患者的Glut-1表达进行研究，并按4分制评分（1：<25%；2：25%-50%；3：50%-75%；4：>75%）。通过Spearman等级相关检验评估Glut-1评分、组织学分级和MIB-1评分之间的关系。发现Glut-1表达与组织学分级（P<0.001）和MIB-1评分（P<0.01）之间存在显著相关性。单因素分析显示，显著的预后因素包括分期（P<0.0001）、组织学分级（P<0.001）和Glut-1表达（P<0.005）。多因素分析后的独立预后因素为分期（P<0.001）和Glut-1表达（P<0.05），Glut-1表达按<50%和>50%分层。Glut-1评分与组织学分级和MIB-1评分的相关性表明，低分化和高增殖性胰腺癌细胞中葡萄糖摄取较高。Glut-1免疫组化表达为胰腺导管腺癌提供了一个有用的预后因素。在PanIN 1中未发现Glut-1表达，但在PanIN 2和3中分别有27.8%和43.8%的病例中发现；在低级别和中级别发育异常的IPMN中未发现Glut-1表达，但在高级别发育异常的IPMN中有60%的病例中发现，这表明Glut-1参与了胰腺癌发生的相对早期阶段。
