标题：食管癌组织中BDNF、TrkB、Ki-67和p63蛋白的表达及临床意义

      作者：赵震，胡惠军，古彩红    惠州市第三人民医院病理科，广东 惠州 516000

      卷次： 2021年32卷24期

      【摘要】 目的 探讨食管癌组织中脑源性神经营养因子(BDNF)、酪氨酸蛋白激酶受体B (TrkB)、增殖细胞核抗原(Ki-67)和肿瘤抑制基因p63蛋白的表达水平及临床意义。方法 回顾性分析2018年7月至2021年4月惠州市第三人民医院收治的 84例食管癌患者的临床资料。采用免疫组织化学两步法检测癌组织及癌旁正常组织的BDNF、TrkB、Ki-67和p63阳性表达水平，采用单因素分析法分析食管癌组织中BDNF、TrkB、Ki-67、p63蛋白阳性表达水平与临床特征的关系。结果 食管癌组织中BDNF、TrkB、Ki-67、p63蛋白阳性表达率分别为73.81%、86.90%、75.00%、84.52%，明显高于癌旁正常组织的9.52%、15.48%、47.62%、27.38%，差异均有统计学意义(P<0.05)；低分化、有淋巴结转移、TNMⅢ~Ⅳ期、深层浸润食管癌组织中的 BDNF阳性表达率分别为 96.15%、91.89%、94.00%、84.91%，明显高于高分化、无淋巴结转移、TNMⅠ~Ⅱ期、浅层浸润的55.88%、59.57%、44.12%、54.84%，低分化、有淋巴结转移、TNMⅢ~Ⅳ期、深层浸润食管癌组织中的TrkB阳性表达率分别为96.15%、100.00%、98.00%、94.34%，明显高于高分化、无淋巴结转移、TNMⅠ~Ⅱ期、浅层浸润的76.47%、76.60%、70.59%、74.19%，差异均有统计学意义(P<0.05)；深层浸润食管癌组织中的Ki-67阳性表达率为84.91%，明显高于浅层浸润的58.06%，差异有统计学意义(P<0.05)；有淋巴结转移食管癌组织中的 p63的阳性表达率为 94.59%，明显高于无淋巴结转移的 76.60%，差异有统计学意义(P<0.05)；BDNF阳性表达与TrkB、Ki-67、p63阳性表达均呈正相关(r=0.415、0.397、0.496，P<0.05)。结论 食管癌组织中BDNF、TrkB、Ki-67、p63蛋白的阳性表达水平均较高，且BDNF和TrkB与肿瘤分化度、淋巴结转移、TNM分期、浸润深度相关，Ki-67与浸润深度相关，p63与淋巴结转移相关，它们可能参与了食管癌的产生、发展。
      【关键词】 食管癌；脑源性神经营养因子；酪氨酸蛋白激酶受体B；增殖细胞核抗原；肿瘤抑制基因p63；病理
      【中图分类号】 R735.1 【文献标识码】 A 【文章编号】 1003—6350（2021）24—3141—04

Expression level and clinical significance of brain-derived neurotrophic factor, tyrosine protein kinase receptorB, proliferating cell nuclear antigen, and tumor suppressor gene p63 protein in esophageal cancer.
ZHAO Zhen, HUHui-jun, GU Cai-hong. Department of Pathology, Huizhou Third People's Hospital, Huizhou 516000,Guangdong, CHINA
【Abstract】 Objective To study the expression levels of brain-derived neurotrophic factor (BDNF), tyrosineprotein kinase receptor B (TrkB), proliferating cell nuclear antigen (Ki-67), and tumor suppressor gene p63 (p63) proteinin esophageal cancer tissues and their clinical significance. Methods The clinical data of 84 patients with esophageal can-cer treated in Huizhou Third People's Hospital from July 2018 to April 2021 were retrospectively analyzed. The two-stepimmunohistochemistry method was used to detect the positive expression levels of BDNF, TrkB, Ki-67, and p63 in cancertissues and normal tissues adjacent to cancer, and single factor analysis method was used to analyze the relationship be-tween the positive expression level of BDNF, TrkB, Ki-67, p63 protein and clinical characteristics in esophageal cancer tis-sue. Results In esophageal cancer tissues, the positive expression rates of BDNF, TrkB, Ki-67, and p63 were 73.81%,86.90%, 75.00%, and 84.52%, respectively, which were significantly higher than 9.52%, 15.48%, 47.62%, and 27.38% ofnormal tissues adjacent to cancer (P<0.05); the positive expression rates of BDNF in esophageal cancer tissue with poorlydifferentiation, lymph node metastasis, TNM Ⅲ-Ⅳ, and deep infiltration were 96.15%, 91.89%, 94.00%, and 84.91%,which were significantly higher than 55.88%, 59.57%, 44.12%, 54.84% in esophageal cancer tissue with well differentia-tion, non-lymph node metastasis, TNMⅠ~Ⅱ, superficial infiltration. The positive expression rates of TrkB in esophagealcancer tissue with poorly differentiation, lymph node metastasis, TNMⅢ-Ⅳ, and deep infiltration were 96.15%, 100.00%,98.00%, 94.34%, significantly higher than 76.47%, 76.60%, 70.59%, 74.19% in esophageal cancer tissue with well-differ-entiation, no lymph node metastasis, TNM stage Ⅰ -Ⅱ, superficial invasion (P<0.05). The positive expression rate ofKi-67 inesophageal cancer tissuewith deep infiltration was 84.91%, which was significantly higher than 58.06% in inesoph-ageal cancer tissue with superficial infiltration (P<0.05). The positive expression rate of p63 in esophageal cancer tissuewith lymph node metastasis was 94.59%, which was significantly higher than 76.60% in esophageal cancer tissue withoutlymph node metastasis (P<0.05). The positive expression of BDNF was positively correlated with the positive expressionof TrkB, Ki-67, and p63 (r=0.415, 0.397, 0.496, P<0.05). Conclusion The positive expression levels of BDNF, TrkB,Ki-67, and p63 protein in esophageal cancer tissues are relatively high, and BDNF and TrkB are related to tumor diffe