上泌尿道癌之凝血酶調節素表現 與患者預後之關連分析

Analyze the correlation between prognosis and TM expression in upperurinary tract carcinoma

李明欣(li ming shin)

指導教授 ： 張清堯

亞洲大學/資訊學院/生物資訊學系碩士班/碩士(2007年)

摘要

國內因上泌尿道癌，包含移形上皮癌 (Transitional Cell Carcinoma，TCC)以及腎臟腫瘤的上皮細胞癌(Renal Cell Carcinoma，RCC)，死亡者人數約在1199人左右，死亡率逐年增加，與西方國家相較，台灣罹患上泌尿道癌的人數每年居高不下。除了烏腳病流行之砷重金屬污染，另因國人不良的用藥習慣、抽煙、肥胖等因素皆被認為是誘發了上泌尿道癌症發生的原因。我們希望分析上泌尿道癌之病患檢體中，凝血酶調節素以及E-cadherin蛋白的表現量的變化，評估其作為病患預後指標的可能。利用免疫化學染色 (Immunohistochemistry stain) 方法，對於所蒐集到的11例上泌尿道癌病患之檢體組織進行染色後量化，主要分成兩大部份為組織部位以及血管部位，檢體正常部位之血管與組織凝血酶調節素與E-cadherin具有一定的表現量，但是對照於病灶部位之血管與組織，兩者之表現量皆下降，進一步評估發現當凝血酶調節素以及E-cadherin蛋白表現量低時，病患的癒後狀況亦表現較差，初步證實E-cadherin具有評估上泌尿道癌預後狀況的意義，但凝血酶調節素卻無明顯的意義。

關鍵字

上泌尿道癌 凝血酶

並列摘要

Abstract
In Taiwan, Transitional cell carcinoma (TCC) of the bladder is the most common malignancy of genitourinary tract, and the most common cause of death of all genitourinary tumors. Renal cell carcinoma (RCC) in kidney account for about 2% of all new cancer cases worldwide and 1199 deaths expected in 2005 in Taiwan. Renal cell carcinoma occurs about twice as often in men as in women. Thrombomodulin (TM) was first described as an integral component of haemostatic pathway in 1981. TM interacts with thrombin to from a high-affinity complex that inhibits thrombin activity and accelerates protein C activation. TM was also suggested identified as a marker of invasive malignancy in vascular tumors. E-cadherin is an adhesion molecule that preserves epithelial structural integrity and whose loss denotes enhanced invasive potential of cancers in many tissue types. In an analogous fashion, loss of TM express is associated with a poor prognosis. In study, we used immunohistochemistry to evaluate whether TM and E-cadherin act as biomarkers for prognosis upperurinary tract carcinoma. We analyzed 11 cases of upper urinary tract carcinoma, and the results show that patients have lower TM or E-cadherin expression have poor prognosis.

並列關鍵字

Analyze the correlation prognosis

參考文獻

1. Huang PC, Huang CY, Huang SW, Lai MK, Yu HJ, Chen J, Pu YS.High incidence of and risk factors for metachronous bilateral upper tract urothelial carcinoma in Taiwan. Int J Urol. 2006 Jul;13(7):864-9.

2. Romero FR, Muntener M, Permpongkosol S, Kavoussi LR, Jarrett TW.Laparoscopic-assisted nephroureterectomy after radical cystectomy for transitional cell carcinoma. Int Braz J Urol. 2006 Nov-Dec;32(6):631-8; discussio n 638-9.

3. Swartz MA, Porter MP, Lin DW, Weiss NS. Incidence of primary urethral carcinoma in the United States，Urology. 2006 Dec;68(6):1164-8. Epub 2006 Dec 4.

4. Sadetzki S, Bensal D, Blumstein T, Novikov I, Modan B. Selected risk factors for transitional cell bladder cancer，Med Oncol. 2000

5. Raitanen MP, Nieminen P, Tammela TL， Impact of tumour grade, stage, number and size, and smoking and sex, on survival in patients with transitional cell carcinoma of the bladder. Br J Urol. 1995 Oct;76(4):470-4.