Lee S E, Chow N H, Chi Y C, Tzai T S, Yang W H, Lin S N
Department of Pathology, Medical College, National Cheng Kung University, Taiwan, ROC.
Anticancer Res. 1994 May-Jun;14(3B):1317-24.
The clinical significance of c-erb B-2 expression in urinary bladder cancer remains controversial. We performed an immunohistochemical study to examine the expression of c-erb B-2 in non-neoplastic urothelium (n = 12) and transitional cell carcinoma of the urinary bladder (n = 82). c-erb B-2 protein was localized in superficial and some intermediate cells of non-neoplastic urothelium. A total of 29 out of 82 (35%) tumors were positive for c-erb B-2 over-expression. There was no significant association of c-erbB-2 expression with tumor grade (p = 0.12), stage (p = 0.93), DNA ploidy status (p = 0.56) and the sex of patients (p = 0.5). Expression of epidermal growth factor receptor and Ki-67 index was available in 33 cases. Both parameters showed no apparent association with c-erbB-2 expression (p = 0.53 and 0.58 respectively). Factors correlated with poor patient survival by univariate analysis were tumor stage (p = 0.0001), tumor grade (p = 0.001), development of second recurrence (p = 0.002) and negative expression of c-erbB-2 (p = 0.017). Important indicators associated with first recurrence were tumor stage (p = 0.028), and c-erbB-2 expression with the risk of second recurrence (p = 0.031). Multivariate survival analysis revealed that tumor stage was among the most important prognostic factors (p = 0.029), followed by tumors without c-erbB-2 expression (p = 0.031) with a median follow-up at 46 months. The age of patients and c-erbB-2 expression were significantly associated with developing second recurrence (p = 0.031 and 0.046 respectively). The results indicate that expression of c-erbB-2 is independent of the stage and grade of bladder cancer. Although c-erbB-2 status can discriminate subpopulations with a high risk of recurrence, evaluation of its expression in paraffin-embedded tumors does not indicate poor prognosis for patients with urinary bladder cancer. To address this discrepancy a better understanding of the regulatory mechanism and physiological properties of c-erbB-2 protein in urothelium is required.
c-erb B-2在膀胱癌中的临床意义仍存在争议。我们进行了一项免疫组织化学研究，以检测c-erb B-2在非肿瘤性尿路上皮（n = 12）和膀胱移行细胞癌（n = 82）中的表达。c-erb B-2蛋白定位于非肿瘤性尿路上皮的表层和一些中间层细胞。82例肿瘤中有29例（35%）c-erb B-2过表达呈阳性。c-erbB-2表达与肿瘤分级（p = 0.12）、分期（p = 0.93）、DNA倍体状态（p = 0.56）及患者性别（p = 0.5）均无显著相关性。33例患者有表皮生长因子受体表达及Ki-67指数数据。这两个参数与c-erbB-2表达均无明显相关性（分别为p = 0.53和0.58）。单因素分析显示，与患者生存不良相关的因素有肿瘤分期（p = 0.0001）、肿瘤分级（p = 0.001）、二次复发（p = 0.002）及c-erbB-2阴性表达（p = 0.017）。与首次复发相关的重要指标是肿瘤分期（p = 0.028）以及c-erbB-2表达与二次复发风险（p = 0.031）。多因素生存分析显示，肿瘤分期是最重要的预后因素之一（p = 0.029），其次是无c-erbB-2表达的肿瘤（p = 0.031），中位随访时间为46个月。患者年龄和c-erbB-2表达与二次复发显著相关（分别为p = 0.031和0.046）。结果表明，c-erbB-2的表达独立于膀胱癌的分期和分级。虽然c-erbB-2状态可区分复发风险高的亚群，但评估其在石蜡包埋肿瘤中的表达并不能表明膀胱癌患者预后不良。为解决这一差异，需要更好地了解c-erbB-2蛋白在上皮中的调控机制和生理特性。
