The Expression Of Ezrin Protein CD44 And E-cadherin In Neuroblastoma And Significance

Background and ObjectiveNeuroblastoma (NB) is one of the most common solid tumors in children, about 50% of neonatal malignant tumors were neuroblastoma and 90% of patients younger than 10 years old. We generally believed that the NB arises from the Nerve sheath of embryonic neural. Most patients with primary lesions located in the retroperitoneum, but can also occur in the mediastinum, pelvic and sympathetic ganglia in the cervical. Incidence parts of neuroblastoma was hidden, and the tumor was highly malignant, early diagnosis is difficult and prone to metastasis. Thus the choice of surgical approach and prognosis caused great difficulties.So we want to detect the exprssion of Ezrin Protein, CD44 and E-cadherin in neuroblastoma. We want to find out their role of invasion and metastasis in NB and relationship between these molecular markers and the prognosis.Material and method:All tumor samples came from First Affiliated Hospital of Zhengzhou University, There are 40 cases from 2007-2009. All the tumors were classified according to the system proposed by INSS 93.In this system the tumor was divided as local stage(Ⅰ, Ⅱ) and advanced stage tumors(Ⅲ,Ⅳ).And according to Shimada classification standards all the tumors were divided into FH and U FH style. And we also divided the children by age(Group A:age<1 year;Group B age≥1 year) and gender(male or female).The staining status was compared of Ezrin Protein, CD44 and E-cadherin in 40 NB patients was detected by two-step immunohist-ochemistry. The chi-square test and Matching tables from analysis of the relationship of two effects were used for the statistics. (p<0.05 was considered significant).Results:1. The relationship between Ezrin protein expression and NB:Ezrin protein expression was significantly higher in NB than that of in the normal adrenal tissue.Strong expression of Ezrin Protein was detected only 15 patients in local stage tumors, but 20 in advanced stage tumors. The difference between the Ezrin Protein expression in the type of local stage tumors and advanced stage tumors was visible (compared local stage tumors, H=6.124, P=0.013)。The expression of Ezrin protein Were found 15 cases in FH classification while 19 cases in UFH. And there is a significant difference between them (H=5.182, P=0.023).2. The relationship between CD44 expression and NB:Study found that CD44 expression in normal adrenal gland was significantly higher than in NB.Strong expression of CD44 was detected 12 patients in local stage tumors, compared with only 6 in advanced stage tumors. The difference between CD44 expression in the type of local stage tumors and advanced stage tumors was visible (compared to advanced stage tumors, H=6.124, P=0.013). The expression of CD44 were found 13 cases in FH classification and 5 cases in UFH. There is a significant difference between them (H=4.496,P=0.034)。3.The relationship between E-cadherin expression and NB:Found that E-cadherin expression in normal adrenal gland was significantly higher than in NB.Strong expression of E-cadherin was detected 11 patients in local stage tumors, compared with just 5 in advanced stage tumors. The difference between E-cadherin expression in the type of local stage tumors and advanced stage tumors was visible (compared to local stage tumors, H=5.455, P=0.020). The expression of E-cadherin Were found 11 cases in FH classification and 5 cases in UFH. There is no significant difference between them (H=2.754,P=0.097).4. The expression of Ezrin protein, CD44 and E-cadherin and their relationship between age and sex:The expression of Ezrin protein in different age with significant difference but there were no significant difference witn CD44 and E-cadherin.There were no significant difference in different genders witn the expression of Ezrin Protein, CD44 and E-cadherin.5. The correlation analysis among Ezrin protein, CD44 and E-cadherin:There were negative crrrelation between the expression of Ezrin and the CD44 (χ2=4.675, P=0.031, r=-0.323).There were also negative crrrelation between the Ezrin and E-cadherin(χ2=6.077,P=0.014, r=-0.123), while positive correlation between CD44 and E-cadherin (χ2=6.077, P=0.014, r=-0.363).ConclusionEzrin Protein,CD44 and E-cadherin expression may be related to metastasis and progression of NB. While Ezrin protein can stimulate tumor metastasis, CD44 and E-cadherin may have an inhibitory effect.Age is one of factors influence the expression of Ezrin protein, but have no influence on CD44 and E-cadherin in neuroblastoma. The gender do not effect on the he expression of Ezrin protein,CD44 and E-cadherin. There were negative crrrelation between the expression of Ezrin Protein and the CD44, Ezrin Protein and the E-cadherin in neuroblastoma, while positive crrrelation between the CD44 and E-cadherin. Ezrin Protein,CD44 and E-cadherin can be very important molecular maker diagnose and therapy neuroblastoma.