Objective: To investigate the expression of syndecan-1 and syndecan-2 and their clinicopathological significance in patients with gallbladder squamous cell (SC)/adenosquamous carcinoma (ASC) and adenocarcinoma (AC). Methods: A total of 126 patients with SC/ASC (n=46) and AC (n=80) were included in this study. The expression levels of syndecan-1 and syndecan-2 were detected by Envison™ immunohistochemistry assay. The clinical and prognostic significance of syndecan-1 and syndecan-2 were analyzed. Results: In the 46 SC/ASC samples, syndecan-1 and syndecan-2 were positively expressed in 29 (63.0%) and 28 (60.9%) tumor tissues, respectively. (Positive expression was defined based on the staining in the component of squamous cell carcinoma. That is to say, the tissue which adenocarcinoma part was positively stained, but squamous cell carcinoma part was negatively stained is also regarded as negative.) In the 80 AC samples, 47 (58.8%) cases showed syndecan-1 positive expression, and 51 (63.8%) showed syndecan-2 positive expression. There was no significant difference in the positive rates of syndecan-1 and syndecan-2 between SC/ASC and AC groups (P>0.05 for all). The levels of syndecan-1 and syndecan-2 were associated with tumor size, TNM staging, lymph node metastasis, invasion of adjacent tissue, and surgical procedures in SC/ASC patients (P<0.05 for all). However, their expression was associated with tumor differentiation, tumor size, TNM staging, lymph node metastasis, invasion of adjacent tissue, and surgical procedures in AC patients (P<0.05 for all). The Kaplan-Meier survival analysis of SC/ASC and AC patients revealed that the average survival time for patients with positive syndecan-1 and syndecan-2 expression was significantly shorter than that of those with negative expression (P<0.01 for all). Cox multivariate analysis indicated that syndecan-1 and syndecan-2 expression were independent unfavorable prognostic factors for SC/ASC and AC patients (P<0.05 for all). Conclusion: The syndecan-1 and syndecan-2 expression are associated with the tumor progression and poor prognosis in patients with gallbladder SC/ASC and AC.
目的： 探讨胆囊鳞癌(SC)、腺鳞癌(ASC)和腺癌(AC)组织中黏结合蛋白多糖1(syndecan－1)和syndecan－2的表达水平及其临床病理意义。 方法： 收集46例胆囊SC和ASC、80例AC患者的肿瘤组织标本，采用EnVision免疫组化法检测syndecan－1和syndecan－2的表达情况，分析其与胆囊SC、ASC和AC患者临床病理特征及预后的关系。 结果： 46例SC和ASC患者中，syndecan－1和syndecan－2阳性表达(以鳞癌成分阳性为准，腺癌成分阳性表达而鳞癌成分阴性表达者也定为阴性表达)分别为29例(63.0%)和28例(60.9%)。80例AC患者中，syndecan－1和syndecan－2阳性表达分别为47例(58.8%)和51例(63.8%)。SC和ASC组与AC组患者的syndecan－1和syndecan－2阳性率差异均无统计学意义(均P>0.05)。syndecan－1和syndecan－2表达与SC和ASC患者的肿瘤最大径、TNM分期、淋巴结转移情况、侵犯周围组织情况和手术方式均有关(均P<0.05)，syndecan－1和syndecan－2表达与AC患者的肿瘤分化程度、肿瘤最大径、TNM分期、淋巴结转移情况、侵犯周围组织情况和手术方式均有关(均P<0.05)。Kaplan－Meier生存分析显示，胆囊SC、ASC和AC患者中，syndecan－1和syndecan－2阳性患者的生存时间明显均低于阴性患者(均P<0.01)。Cox多因素分析显示，syndecan－1和syndecan－2表达情况为影响胆囊SC、ASC和AC患者预后的独立因素(均P<0.05)。 结论： syndecan－1和syndecan－2表达情况反映了胆囊SC、ASC和AC的进展、生物学行为和预后，syndecan－1和syndecan－2阳性的胆囊SC、ASC、AC患者预后不良。.
Keywords: Clinicopathological features; Gallbladder neoplasms; Immunohistochemistry; Prognosis; Syndecan-1; Syndecan-2.