TGF-β1和Smad4在膀胱癌中的表达及其与淋巴结转移的关系

目的：观察转化生长因子β1（TGF-β1）和Smad4在膀胱癌组织内的表达情况，并分析其与膀胱癌淋巴管生成及淋巴结转移之间的关系。方法：选择在本院确诊的膀胱癌患者50例，根据淋巴结转移与否分为淋巴结转移组（30例）和无淋巴结转移组（20例1。应用免疫组化法检测膀胱癌组织内TGF-β1和Smad4的表达。以D2—40作为淋巴管内皮特异性标记物，检测膀胱癌组织内淋巴管生成情况并分析其与TGF-β1和Smad4的表达的关系。结果：TGF．B1主要表达于膀胱癌细胞胞浆内，在淋巴结转移组的表达率明显高于无淋巴结转移组（P=0．017）。Smad4表达于膀胱癌细胞胞浆和胞核内，在无淋巴结转移组的表达率明显高于有淋巴结转移组（P=0．005）。Smad4表达阳性组的淋巴管数密度（LVD）明显低于Smad4表达阴性组（P=0．037）。TGF-p1的表达与Smad4的表达呈显著的负相关性（P=0．001）。结论：TGF-β1的表达与膀胱癌淋巴管生成及淋巴结转移呈显著正相关，Smad4的表达与膀胱癌淋巴管生成及淋巴结转移呈显著负相关，TGF-β1／Smad4信号通路可能在膀胱癌淋巴管生成和淋巴结转移过程中起重要作用。

Correlation of TGF-β1 an.d Smad4 Expression with Lymph Node Metastasis in Bladder Cancer

Objective： To investigate the correlation of transforming growth factor β1 （TGF-β1） and Smad4 with the lymphangiogenesis and lymph node metastasis of bladder cancer. Methods： Fifty paraffin-embedded specimens from patients with bladder cancer were included in this study.and divided into lymph node metastatic group （n=30） and nonmetastatic group （n=20）. The expressions of TGF-β1 and Smad4 were detected by immunohistochemical stain in bladder cancer. D2-40 was used as the specific lymphatic endotheli- al marker for detecting lymphangiogenesis. Results： TGF-β 1 protein was observed predominantly in the cytoplasm of the tumor cells, the expression of TGF-β1 in lymph node metastatic group was significantly higher than that in nonmetastatic group（P=0.017）. Smad4 protein was observed in cytoplasm and nucleus of tumor cells, the expression of Smad4 in nonmetastatic group was significantly higher than that in lymph node metastatic group（P=0.005）. The lymphatic vessel density（LVD） in Smad4 positive group was significantly decreased than that in Smad4 negative group （P=0.037）. TGF-31 expression was negatively correlated with Smad4 expression in bladder cancer（P=0. 001）. Conclusion： TGFq31 expression was positively correlated with lymphagiogenesis and lymph node metastasis, whereas Smad4 expression showed negative correlation with lymphangiogenesis and lymph node metastasis in bladder cancer, which indicated that TGF-β1/Smad4 signal pathway may play an important role in the lymphangiogenesis and lymph node metastasis of bladder cancer.