L1-CAM在乳腺浸润性微乳头状癌的表达及其意义

摘要

Objective: The study aims to investigate the expression of L1 cell adhesion molecules (L1-CAM) in invasion micropapillary carcinoma (IMPC) and to analyze its clinical significance. Methods: L1-CAM expression was analyzed in 97 IMPC cases and 95 invasive ductal carcinoma–not otherwise specified (IDC-NOS) cases via immunohistochemistry. The correlation of L1-CAM expression with clinicopathologic characteristics, which include the prognosis IMPC patients, was determined. Results: The rate of L1-CAM expression in IMPC (50.5%) is significantly higher than that of IDC-NOS (18.9%). L1-CAM expression is also associated with histological grade, vessel invasion, lymph node metastasis, L1-CAM vessels, and protein p53 expression (P<0.05), whereas it is negatively associated with ER and PR (P<0.05). L1-CAM was predominantly expressed in the cell-cell interface of the cell clusters of IMPC and in the stroma vascular en-dothelial cells. Univariate analysis results indicate that expression of L1 is a risk factor that can predict the survival of IMPC patients (P<0.05). Multivariate analyses results from a Cox's proportional hazards model show that a high expression of L1-CAM is an independent risk factor for the death of IMPC patients. Conclusion: This study suggests that L1-CAM expression may have an important function in collective cell growth and is significantly associated with tumor invasion and metastasis. L1-CAM can be considered as biomarkers of prognosis and as a new target for IMPC therapy.%　　目的：探讨 L1细胞黏附分子(L1 cell adhesion molecules,L1-CAM)在乳腺浸润性微乳头状癌(Invasive micropapillary carcinoma,IMPC)中的表达及其临床意义.方法：应用免疫组织化学SP法,检测97例乳腺IMPC中L1-CAM表达,并以95例浸润性导管癌非特殊型(invasive ductal carcinoma,not otherwise specified,IDC-NOS)作为对照组.分析L1-CAM在IMPC的表达及与临床病理学特征和预后的关系.结果：L1-CAM表达于肿瘤细胞膜及间质中的脉管内皮细胞,在IMPC组主要表达于肿瘤细胞集团内细胞间的相互连接面.L1-CAM在IMPC中的表达率(50.5%)显著高于IDC-NOS组(18.9%),并与IMPC的组织学分级、脉管侵犯、淋巴结转移、间质内脉管的L1-CAM表达及肿瘤细胞的P53表达呈正相关(P<0.05),与ER、PR表达呈负相关(P<0.05).单因素分析结果显示,IMPC患者中L1-CAM表达阳性患者预后不良.多因素分析结果显示IMPC中L1-CAM表达是影响患者术后生存的独立预后因素.结论：L1-CAM可能在IMPC集团性生长、侵袭、转移中发挥重要作用,可作为IMPC预后预测的标志物及靶向治疗研究的新靶点.