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目的:探讨Maspin蛋白在原发性胆管癌中的表达和意义及其与p53蛋白的关系。方法:用免疫组化法检测42例胆管癌连同癌旁组织及12例正常胆管组织中Maspin蛋白和p53蛋白的表达,分析两者与患者临床病理因素及预后的关系以及两者之间的关系。结果:Maspin蛋白与p53蛋白在胆管癌组织中阳性率均明显高于癌旁组织与正常胆管组织(均P<0.05);Maspin蛋白表达与胆管癌淋巴结转移及远处转移有关,而p53蛋白表达与胆管癌病理分级、TNM分期、淋巴结转移以及远处转移有关(均P<0.05),但胆管癌中Maspin蛋白与p53蛋白表达无相关性(r=-0.329,P=0.144)。Maspin阳性表达患者术后生存期长于阴性表达患者(χ~2=4.440,P=0.035),而p53阳性表达患者术后生存期短于阴性表达患者(χ~2=8.231,P=0.004)。单因素与多因素Cox回归模型分析结果显示,Maspin蛋白是胆管癌患者预后的独立预测指标(HR=0.094,95%CI=0.015~0.593,P=0.012)。结论:Maspin蛋白在胆管癌组织中表达增加,但其减少或缺失可能与患者不良临床病理特征及预后密切相关,且其作用机制可能与p53蛋白无关联。
Objective: To investigate the expression and significance of Maspin protein in primary cholangiocarcinoma and its relationship with p53 protein. Methods: The expressions of Maspin protein and p53 protein in 42 cases of cholangiocarcinoma with adjacent tissues and 12 cases of normal bile duct tissues were detected by immunohistochemical method. The relationship between them and the clinicopathologic factors and prognosis of the patients and the relationship between the two were analyzed. . RESULTS: The positive rates of Maspin protein and p53 protein in cholangiocarcinoma were significantly higher than those in para-cancer tissue and normal bile duct tissue (both P<0.05). The expression of Maspin protein was related to lymph node metastasis and distant metastasis of cholangiocarcinoma, and the expression of p53 protein. It was associated with pathological grade, TNM staging, lymph node metastasis, and distant metastasis of cholangiocarcinoma (all P<0.05). However, there was no correlation between Maspin protein and p53 protein expression in cholangiocarcinoma (r=-0.329, P=0.144). Patients with Maspin-positive expression had longer survival than patients with negative expression (χ~2=4.440, P=0.035). Patients with p53-positive expression had a shorter survival time than patients with negative expression (χ~2=8.231, P=0.004). Univariate and multivariate Cox regression models showed that Maspin protein was an independent predictor of prognosis in patients with cholangiocarcinoma (HR=0.094, 95%CI=0.015~0.593, P=0.012). Conclusion: Expression of Maspin protein is increased in cholangiocarcinoma tissues, but its decrease or absence may be closely related to poor clinicopathologic features and prognosis of patients, and its mechanism may not be related to p53 protein.