Liu Dong-cai, Yang Zhu-lin
Departemt of Geriatric Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, China.
Zhonghua Wai Ke Za Zhi. 2011 Mar 1;49(3):250-5.
To study the expression of ephrin-A7 (EphA7) and metadherin (MTDH) and their clinicopathological significances in the benign and malignant lesions of gallbladder.
EnVisiom immunohistochemical methods was used for determining the expressions of EphA7 and MTDH in routinely paraffin-embedded sections of surgically-resected specimens from 108 cases with gallbladder adenocarcinoma, 15 cases with adenomatous polyp and 35 cases with chronic cholecystitis treated from June 1996 to June 2006. And 46 cases of peritumoral tissues were also harvested as controls (n = 35).
The positive expression rates of EphA7 and MTDH were significantly higher in gallbladder adenocarcinoma than those in peritumoral tissues (χ(2)(EphA7) = 12.65, χ(2)(MTDH) = 13.00; P < 0.01), adenomatous polyp (χ(2)(EphA7) = 8.21, χ(2)(MTDH) = 9.39; P < 0.01) and chronic cholecystitis (χ(2)(EphA7) = 21.21, χ(2)(MTDH) = 23.68; P < 0.01); Moderately-or severely-atypical hyperplasia of gallbladder epithelium was found in the benign lesions with positive expression of EphA7 and/or MTDH. The positive rates of EphA7 and MTDH were significantly lower in the cases of well-differentiated adenocarcinoma, maximal diameter of tumor < 2 cm, no-metastasis of lymph node, and tumor with no-invasiveness of regional tissues than those in the poorly-differentiated adenocarcinoma (χ(2)(EphA7) = 12.34, χ(2)(MTDH) = 12.80; P < 0.01), maximal diameter of tumor ≥ 2 cm (χ(2)(EphA7) = 5.22, χ(2)(MTDH) = 5.00; P < 0.05), cases with metastasis of lymph node (χ(2)(EphA7) = 5.15, χ(2)(MTDH) = 5.86; P < 0.05) and cases with invasiveness of regional tissues (χ(2)(EphA7) = 7.06, P < 0.01; χ(2)(MTDH) = 4.13; P < 0.05) in gallbladder adenocarcinoma (P < 0.05). The high consistency was found between the expressive levels of EphA7 and MTDH in gallbladder adenocarcinoma (χ(2) = 13.11, P < 0.01). The univariate Kaplan-Meier analysis showed that the increased expression of EphA7 (P = 0.023) and MTDH (P = 0.034) was negatively associated with the overall survival. The multivariate Cox regression analysis showed that increased expression of EphA7 and/or MTDH (P(EphA2) = 0.023, P(MTDH) = 0.034) was an independent poor-prognostic predictor for gallbladder adenocarcinoma.
The expression of EphA7 and/or MTDH might be closely related to the carcinogenesis, progression, clinical biological behaviors and prognosis of gallbladder adenocarcinoma. The positive expression of EphA7 and/or MTDH may predict bad-prognosis in gallbladder adenocarcinoma.
研究ephrin - A7（EphA7）和间黏附素（MTDH）在胆囊良恶性病变中的表达及其临床病理意义。
采用EnVisiom免疫组化方法检测1996年6月至2006年6月手术切除的108例胆囊腺癌、15例腺瘤性息肉及35例慢性胆囊炎患者常规石蜡包埋标本中EphA7和MTDH的表达。同时采集46例癌旁组织作为对照（n = 35）。
EphA7和MTDH在胆囊腺癌中的阳性表达率显著高于癌旁组织（χ(2)(EphA7)=12.65，χ(2)(MTDH)=13.00；P < 0.01）、腺瘤性息肉（χ(2)(EphA7)=8.21，χ(2)(MTDH)=9.39；P < 0.01）及慢性胆囊炎（χ(2)(EphA7)=21.21，χ(2)(MTDH)=23.68；P < 0.01）；EphA7和/或MTDH阳性表达的良性病变中可见胆囊上皮中度或重度非典型增生。EphA7和MTDH在高分化腺癌、肿瘤最大径<2 cm、无淋巴结转移及无区域组织浸润的胆囊腺癌中的阳性率显著低于低分化腺癌（χ(2)(EphA7)=12.34，χ(2)(MTDH)=12.80；P < 0.01）、肿瘤最大径≥2 cm（χ(2)(EphA7)=5.22，χ(2)(MTDH)=5.00；P < 0.05）、有淋巴结转移的病例（χ(2)(EphA7)=5.15，χ(2)(MTDH)=5.86；P < 0.05）及有区域组织浸润的病例（χ(2)(EphA7)=7.06，P < 0.01；χ(2)(MTDH)=4.13；P < 0.05）（P < 0.05）。EphA7和MTDH在胆囊腺癌中的表达水平具有高度一致性（χ(2)=13.11，P < 0.01）。单因素Kaplan - Meier分析显示，EphA7（P = 0.023）和MTDH（P = 0.034）表达增加与总生存期呈负相关。多因素Cox回归分析显示，EphA7和/或MTDH表达增加（P(EphA2)=0.023，P(MTDH)=0.034）是胆囊腺癌独立的不良预后预测指标。
EphA7和/或MTDH的表达可能与胆囊腺癌的发生、发展、临床生物学行为及预后密切相关。EphA7和/或MTDH的阳性表达可能预示胆囊腺癌预后不良。
