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目的 探讨CD15抗原和组织蛋白酶D(Cath-D)在食管癌的表达意义及其相互关系。 方法 应用微波-LSAB免疫组化法,观察65例食管癌组织(男46例,女19例;平均年龄54岁;均为鳞癌)中CD15和Cath-D的表达阳性率及其相互关系。 结果 食管癌CD15和CD阳性率分别为58％(38/65例)和65％(42/65例);食管癌CD15和Cath-D表达与性别、年龄、肿瘤部位、大体类型及肿瘤大小无关(P>0.05)。CD15和Cath-D表达阳性率:鳞癌Ⅲ级(88％,14/16 vs 100％,16/16)均显著高于鳞癌Ⅰ级(43％,6/14 vs 50％,7/14)和鳞癌Ⅱ级(51％,18/35 vs 54％,19/35,P<0.05);外膜层浸润(74％,20/27 vs82％,22/27)显著高于肌层浸润(47％,18/38 vs 53％,20/38,P<0.05);有淋巴结转移组(72％,26/36 vs 78％,28/38)显著高于无淋巴结转移组(41％,12/29 vs 48％、14/29,P<0.025);死亡组(70％,31/44 vs 77％,34/44)显著高于五年生存组(33％,7/21 vs 38％,8/21,P<0.01)。CD15阳性的肿瘤Cath-D阳性率显著高于CD15阴性者(82％,31/38 vs41％,11/27),CD15表达与Cath-D表达呈正相关(r=0.42,P<0.01)。 结论 检测CD15和Cath-D表达对判断食管癌恶性程度、预测其侵袭转移趋势和预后及指导治疗有重要意义。食管癌CD15与Cath-D表达具有相互协同作用可能。
Objective To investigate the expression of CD15 antigen and cathepsin D (Cath-D) in esophageal cancer and their relationship. Methods The expression of CD15 and Cath-D in 65 cases of esophageal cancer tissues (46 males and 19 females; mean age 54 years; all squamous cell carcinomas) were examined by microwave-LSAB immunohistochemistry. Results The positive rates of CD15 and CD in esophageal cancer were 58% (38/65) and 65% (42/65) respectively. The expressions of CD15 and Cath-D in esophageal cancer were not related to sex, age, tumor location, gross type and tumor size (P> 0.05). The positive rates of CD15 and Cath-D expression in squamous cell carcinoma were significantly higher than those in grade I squamous cell carcinoma (88%, 14/16 vs 100%, 16/16) (43%, 6/14 vs 50%, 7/14 (51%, 18/35 vs 54%, 19/35, P <0.05). The outer membrane invasion (74%, 20/27 vs 82%, 22/27) was significantly higher than that of myometrial invasion (47%, 18/38 vs 53%, 20/38, P <0.05). The rate of lymph node metastasis was significantly higher in those with lymph node metastasis (72%, 26/36 vs 78%, 28/38) than those without lymph node metastasis (41% (70%, 31/44 vs 77%, 34/44) in the death group was significantly higher than that in the five-year survival group (33% vs 7/21 vs 38%, P <0.025) , 8/21, P <0.01). The positive rate of Cath-D in CD15-positive tumors was significantly higher than that in CD15-negative ones (82%, 31/38 vs 41%, 11/27). There was a positive correlation between CD15 expression and Cath-D expression (r = 0.42, P <0.01). Conclusions The detection of CD15 and Cath-D expression is of great significance in judging the malignant degree of esophageal cancer, predicting the invasion and metastasis tendency, prognosis and guiding treatment. Esophageal cancer CD15 and Cath-D expression may have synergistic effect with each other.