膀胱副神经节瘤组织中SDHB、EPAS1及Ki⁃67表达的研究
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国家自然科学基金青年基金(81902565)


Expressions of SDHB,EPAS1 and ki⁃67 in paraganglioma of bladder
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    摘要:

    目的:探讨膀胱副神经节瘤临床病理特征以及琥珀酸脱氢酶B(succinate dehyrogenase B,SDHB)、内皮PAS区域蛋白1(EPAS1)及Ki-67在膀胱副神经节瘤中的表达情况,以及三者作为预测恶性副神经节瘤指标的意义。方法:回顾性分析本院收治的43例膀胱副神经节瘤患者的临床病理资料,对43例标本行SDHB、EPAS1、CgA、Ki-67免疫组化检测,并分析其作为预测恶性副神经节瘤指标的意义。结果:43例中,男24例,女19例;年龄26~81岁,中位年龄68岁;随访时间2~84个月,中位随访时间51.3个月;3例死亡,9例术后转移,4例术后反复复发,无转移;其余无复发及转移。良性30例,镜下表现为肿瘤细胞呈经典的巢状排列,核分裂及坏死罕见,瘤细胞巢周围有支持细胞包绕。SDHB阴性(-)4例,EPAS1强阳性(+++)14例,CgA强阳性(+++)18例,2例Ki-67≥3%。恶性13例,镜下表现为肿瘤细胞呈弥漫浸润性生长或大巢状分布,核分裂多见,可见肿瘤性坏死及脉管内瘤栓。SDHB阴性(-)8例,EPAS1强阳性(+++)9例;CgA强阳性(+++)10例;11例Ki-67≥3%。SDHB阴性(-)肿瘤中66.7%为恶性,SDHB阳性(+)的肿瘤中16.1%为恶性,两组比较差异有统计学意义(P<0.05)。SDHB 阴性(-)肿瘤中EPAS1、CgA表达强度以及Ki-67≥3%的比例明显高于SDHB阳性(+)肿瘤。恶性膀胱副神经节瘤中EPAS1、CgA、Ki-67阳性表达率明显高于良性膀胱副神经节瘤。结论:恶性膀胱副神经节瘤组织中SDHB免疫组化阴性率为66.7%,SDHB阴性的膀胱副神经节瘤组织中EPAS1过表达,EPAS1阳性表达强度与CgA及Ki-67高表达呈正相关。SDHB、EPAS1、Ki-67是预测恶性膀胱副神经节瘤的生物学指标。

    Abstract:

    Objective:This study aims to investigate the clinicopathological features of paraganglioma of the bladder and the expression of succinate dehyrogenase B(SDHB),EPAS1 and Ki-67 in pheochromocytoma of the bladder,and its significance for predicting the clinical malignant behavior. Methods:The clinical and pathological data of 43 patients with cystoparaglioma admitted to our hospital were retrospectively analyzed,and the immunohistochemical tests of SDHB,EPAS1,CgA and Ki-67 were performed on 43 samples,and their significance as indicators for the prediction of malignant paraglioma was analyzed. Results:There were 43 cases of bladder paraganglioma in 19 females and 24 males. Ages 26-81,median age 68. The follow-up time was 2-84 months,with a median follow-up time of 51.3 months. There were 3 deaths,9 cases with postoperative metastasis,and 4 cases with recurrent recurrence without metastasis. The rest had no recurrence or metastasis. Microscopically,the neoplastic cells in 30 patients presented classic nest-like arrangement,with rare nuclear division and necrosis,and supporting cells surrounding the nests of neoplastic cells. SDHB expression was negative(-)in 4 cases,EPAS1 expression was strongly positive(+++)in 14 cases,CgA expression was strongly positive(+++)in 18 cases,and Ki-67 expression was ≥3% in 2 cases. Microscopically,there were 13 cases of malignancy. The tumor cells showed diffuse invasive growth or large nests,and nuclear division was common. Neoplastic necrosis and intrascularly neoplastic thrombus were seen. SDHB expression was negative(-)in 8 cases,EPAS1 expression was strong positive(+++)in 9 cases. There were 10 cases with strong positive CgA(+++) expression,11 cases with Ki-67 ≥3%. Among the SDHB negative tumors,66.7% was malignant,and among the SDHB positive tumors,16.1% was malignant. The difference between the two groups was statistically significant(P < 0.05). The expression intensity of EPAS1 and CgA and the proportion of Ki-67 ≥3% in SDHB negative tumors were significantly higher than that in SDHB positive tumors. The positive expression rates of EPAS1,CgA and Ki-67 in malignant cystoparaglioma were significantly higher than that in benign cystoparaglioma. Conclusion:The negative rate of SDHB immunohistochemistry in the tissues of malignant cystoganglioma was 66.7%. In the tissues of cystoganglioma with negative SDHB expression,EPAS1 was overexpressed,and the positive expression intensity of EPAS1 was positively correlated with the high expression of CgA and Ki-67. SDHB,EPAS1 and Ki-67 are the biological indicators for the prediction of malignant cystoparaglioma.

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朱逸之,周晓莉,顾文贤,张力峰,孙阳阳.膀胱副神经节瘤组织中SDHB、EPAS1及Ki⁃67表达的研究[J].南京医科大学学报(自然科学版),2020,(12):1774-1778

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  • 收稿日期:2020-05-30
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  • 在线发布日期: 2021-01-04
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