Wu Zheng-Chun, Xiong Li, Wang Ling-Xiang, Miao Xiong-Ying, Liu Zi-Ru, Li Dai-Qiang, Zou Qiong, Liu Kui-Jie, Zhao Hua, Yang Zhu-Lin
Zheng-Chun Wu, Li Xiong, Ling-Xiang Wang, Xiong-Ying Miao, Zi-Ru Liu, Kui-Jie Liu, Hua Zhao, Zhu-Lin Yang, General Surgery Department, Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China.
World J Gastroenterol. 2017 Apr 14;23(14):2601-2612. doi: 10.3748/wjg.v23.i14.2601.
To investigate the expression and clinical pathological significance of ROR2 and WNT5a in gallbladder squamous/adenosquamous carcinoma (SC/ASC) and adenocarcinoma (AC).
EnVision immunohistochemistry was used to stain for ROR2 and WNT5a in 46 SC/ASC patients and 80 AC patients.
Poorly differentiated AC among AC patients aged > 45 years were significantly more frequent compared with SC/ASC patients, while tumors with a maximal diameter > 3 cm in the SC/ASC group were significantly more frequent compared with the AC group. Positive ROR2 and WNT5a expression was significantly lower in SC/ASC or AC with a maximal mass diameter ≤ 3 cm, a TNM stage of I + II, no lymph node metastasis, no surrounding invasion, and radical resection than in patients with a maximal mass diameter > 3 cm, TNM stage IV, lymph node metastasis, surrounding invasion, and no resection. Positive ROR2 expression in patients with highly differentiated SC/ASC was significantly lower than in patients with poorly differentiated SC/ASC. Positive ROR2 and WNT5a expression levels in highly differentiated AC were significantly lower than in poorly differentiated AC. Kaplan-Meier survival analysis showed that differentiation degree, maximal mass diameter, TNM stage, lymph node metastasis, surrounding invasion, surgical procedure and the ROR2 and WNT5a expression levels were closely related to average survival of SC/ASC or AC. The survival of SC/ASC or AC patients with positive expression of ROR2 and WNT5a was significantly shorter than that of patients with negative expression results. Cox multivariate analysis revealed that poor differentiation, a maximal diameter of the mass ≥ 3 cm, TNM stage III or IV, lymph node metastasis, surrounding invasion, unresected surgery and positive ROR2 or WNT5a expression in the SC/ASC or AC patients were negatively correlated with the postoperative survival rate and positively correlated with mortality, which are risk factors and independent prognostic predictors.
SC/ASC or AC patients with positive ROR2 or WNT5a expression generally have a poor prognosis.
探讨ROR2和WNT5a在胆囊鳞癌/腺鳞癌（SC/ASC）及腺癌（AC）中的表达情况及其临床病理意义。
采用EnVision免疫组化法对46例SC/ASC患者和80例AC患者的ROR2和WNT5a进行染色。
年龄>45岁的AC患者中低分化AC的发生率显著高于SC/ASC患者，而SC/ASC组中最大直径>3 cm的肿瘤发生率显著高于AC组。最大肿块直径≤3 cm、TNM分期为I + II期、无淋巴结转移、无周围组织侵犯且行根治性切除术的SC/ASC或AC患者中，ROR2和WNT5a阳性表达显著低于最大肿块直径>3 cm、TNM分期为IV期、有淋巴结转移、有周围组织侵犯且未行切除术的患者。高分化SC/ASC患者中ROR2阳性表达显著低于低分化SC/ASC患者。高分化AC患者中ROR2和WNT5a阳性表达水平显著低于低分化AC患者。Kaplan-Meier生存分析显示，分化程度、最大肿块直径、TNM分期、淋巴结转移、周围组织侵犯、手术方式以及ROR2和WNT5a表达水平与SC/ASC或AC患者的平均生存期密切相关。ROR2和WNT5a表达阳性的SC/ASC或AC患者的生存期显著短于表达阴性的患者。Cox多因素分析显示，SC/ASC或AC患者中低分化、肿块最大直径≥3 cm、TNM分期为III或IV期、淋巴结转移、周围组织侵犯、未行切除手术以及ROR2或WNT5a表达阳性与术后生存率呈负相关，与死亡率呈正相关，是危险因素及独立的预后预测指标。
ROR2或WNT5a表达阳性的SC/ASC或AC患者总体预后较差。
