A clinicopathological study of the expression of extracellular matrix components in urothelial carcinoma
A clinicopathological study of the expression of extracellular matrix components in urothelial carcinoma
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DOI：
10.1111/j.1464-410x.2005.05357.x
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发表时间：
2005-03-01
影响因子：
4.5
通讯作者：
Malamou-Mitsi, V
中科院分区：
文献类型：
--
作者：
Ioachim, E;Michael, M;Malamou-Mitsi, V
目的检测细胞外基质(ECM)组分Tenascin、FN、IV型胶原和层粘连蛋白(LN)在尿路上皮癌中的免疫组织化学表达，并与临床病理特征进行相关性分析，以探讨这些分子在肿瘤发生发展中的作用及预后价值。Tenascin、FN、IV型胶原和层粘连蛋白的表达与临床病理特征(肿瘤分级和分期、多发性、同时原位成分、增殖相关指数Ki-67和增殖细胞核抗原判断的增殖活性、复发率和肿瘤侵袭进展)相关。对28例浅表性膀胱癌患者行TURBT治疗，53例行TURBT加干扰素膀胱内灌注治疗。结果20%的患者肿瘤细胞中有Tenascin表达。Tenascin在76%的肿瘤间质中表达，并与肿瘤分级、分期呈正相关。间质Tenascin的表达与肿瘤的增殖活性呈正相关，与FN和IV型胶原的表达呈正相关。89%的肿瘤间质有FN的表达，且与肿瘤分期、增殖活性、IV型胶原和层粘连蛋白的表达呈正相关。93%的标本表达IV型胶原，且与肿瘤分级、分期呈正相关。层粘连蛋白在78%的标本中表达，与临床病理特征无明显相关性。单纯接受TURBT治疗且Tenascin水平低的患者比TURBt高水平患者有更长的无瘤间隔时间。结论TURBt患者TURBt水平对预测早期复发风险有价值。Tenascin、丝连蛋白和IV型胶原的表达似乎与更具侵袭性的肿瘤行为有关。此外，它们的相互关系可能表明它们参与了膀胱癌组织的重塑，可能影响肿瘤的进展。
OBJECTIVETo measure the immunohistochemical expression of the extracellular matrix (ECM) components tenascin, fibronectin, collagen type IV and laminin in urothelial carcinomas, and to correlate their expression with clinicopathological features to clarify the prognostic value of these molecules and their role in tumour progression.MATERIALS AND METHODSTumour specimens obtained during transurethral resection of bladder tumour (TURBT) from 103 patients (82 men and 2 1 women, mean age 66.7 years, range 27-89) were studied retrospectively. The expression of tenascin, fibronectin, collagen type IV and laminin was correlated with clinicopathological features (tumour grade and stage, multiplicity, simultaneous in situ component, the proliferative activity as estimated by the two proliferation associated indices, Ki-67 and proliferating cell nuclear antigen, the recurrence rate, and the progression of invading tumour). Specimens investigated for tenascin expression from patients with superficial bladder cancers were categorized into 28 treated by TURBT only and 53 who had TURBT followed by intravesical instillations of interferon.RESULTSCytoplasmic tenascin expression was detected in tumour cells in 20% of specimens. Tenascin was expressed in the tumour stroma in 76% of specimens, and was positively correlated with tumour grade and stage. Stromal tenascin expression was positively correlated with proliferative activity, and with the expression of filbronectin and collagen type IV. Fibronectin was expressed in the tumour stroma in 89% of specimens and was positively correlated with tumour stage, proliferative activity, and expression of collagen type IV and laminin. Collagen type IV was expressed in 93% of specimens, and was positively correlated with tumour grade and stage. Laminin was expressed in 78% of specimens and had no significant correlation with the clinicopathological features. Patients treated with TURBT alone and who had low levels of tenascin had a longer tumour-free interval than those with high levels of tenascin.CONCLUSIONLevels of tenascin might be valuable for predicting the risk of early recurrence. The expression of tenascin, filbronectin and collagen type IV seems to be correlated with more aggressive tumour behaviour. Furthermore, their interrelationships could indicate that they are involved in the remodelling of bladder cancer tissue, probably influencing tumour progression.