摘要目的 探讨肿瘤干细胞标志物CD44v6和CD24在卵巢浆液性癌中的表达特点及其与临床病理参数及预后的关系.方法 收集解放军总医院病理科2001年6月至2010年12月卵巢浆液性癌手术切除标本102例,采用两级病理分级系统判定组织学分级,免疫组织化学EnVision二步法检测癌组织中CD44v6和CD24的表达,结合随访结果分析其与卵巢浆液性癌发生发展的关系.结果 102例卵巢浆液性癌病例中,47例(46.1％) CD44v6呈阳性表达,61例(59.8％) CD24为阳性表达.CD44v6和CD24在病理分级高级别组中阳性表达率明显高于低级别组,差异有统计学意义(P=0.003,P＜0.05);CD24阳性表达与淋巴结转移相关(P＜0.05).两种标志物表达水平无明显相关性(X2 =0.394,P=0.530).年龄、病理分级、临床分期及淋巴结转移与患者无瘤生存时间相关(P＜0.05),CD44v6阳性表达及病理分级是影响总体生存的重要因素(P＜0.05),年龄是卵巢浆液性癌患者独立的预后影响因子.结论 CD44v6高表达、年龄≥50岁、临床分期为进展期及淋巴结有转移是卵巢浆液性癌患者预后的不良因素.两级病理分级系统与卵巢浆液性癌预后关系密切,高级别可作为预后不良的重要预测因子.

abstractsObjective To study the expression and clinicopathologic significance of cancer stem cell markers CD44v6 and CD24 in ovarian serous carcinoma tissues.Methods One hundred and two cases of ovarian carcinoma diagnosed during the period from June,2001 to December,2010 were retrieved from archival files.The histology slides were reviewed and a two-tier system for grading of ovarian serous carcinoma was applied.The expression of CD44v6 and CD24 was detected by immunohistochemistry using EnVision method.The relationship between CD44v6/CD24 expression and various clinicopathologic parameters was analyzed.Results There were 46.1％ (47/102) and 59.8％ (61/102) cases expressing CD44v6 and CD24,respectively.Both CD44v6 and CD24 expression showed positive correlation with higher histopathologic grade (P =0.003 and P ＜ 0.05,respectively).CD24 expression also correlated with the presence of lymph node metastasis (P ＜ 0.05).There was no statistically significant relationship between the expression of these two markers (x2 =0.394,P =0.530).The age of the patients,histopathologic grade,clinical stage and nodal status correlated with progression-free survival time (P ＜ 0.05).CD44v6 expression and histopathologic grade correlated with the overall survival time (P ＜ 0.05).Patient age was an independent poor prognostic factor by multivariate analysis.Conclusions CD44v6 expression,age older than 50 years,high clinical stage and presence of lymph node metastasis are associated with poor prognosis in patients with ovarian serous carcinoma.The two-tier system for grading of ovarian serous carcinoma is useful in predicting survival; and high tumor grade represents an important poor prognostic indicator for ovarian serous carcinoma.