| objective:Cutaneous malignant melanoma(CMM) is a higly malignant skin cancer,which often occur tumour metastasis and recurrence,so the medium and advanced patients with the CMM always have a poor clinical prognosis.At present, the foreign and domestic researches have developed some new anti-cancer drugs and treatment protocols,on the basis of studying the mechanism of the tumorigenesis and progression,however,the new drugs have better effect than the conventional medicine,the overrall survival of the pateints treated by the new drugs do not get signifcantly prolonged,so we need deeply research the mechanism. The proteins of Wip1、Shh and Glil highly express in human breast cancer、lung cancer and other human maligant tumors, theirs inhibitors have palyed an important role in restricting the tumor growth and metastasis and the expression of these proteins are closely related with the prognosis therefore this study is designed to detect the protein of Wip1、Shh and Gli1 expressed between the cutaneous malignant melanoma(CMM) and the Pigmented Nevus,to explore the relation among the three protein and the relation between the positive expression of the three protein and the clinical stage and prognosis of the cutaneous malignant melanoma.preliminary explore the interaction of each protein expression and the impact on the prognosis of patient with cutaneous malignant melanoma. this study could provide the guiding significance of the signaling pathway blockers in study of the CMM treatment and a reference for the prognosis evaluation indicator of patient with CMM.Mehtods:1. The thirty one case of medical records included particular date of patient were collected (all the patient have no radiotherapy and chemotherapy before and after the diagnosis),who were diagnosed the CMM by the department of dermatology or pathology in the Affiliated Hospital of Luzhou Medical College,from the January 2004 to January 2012,the other thirty one case of medical records of patient who were diagnosed as the Pigmented Nevus by the department of dermatology or plastic surgery in this hospital,this team is the control group. Telephone and mail to follow-up the disease progression of patient during 3 years after the first diagnosis.2.The clinical stage was divided according to the the seventh edition of tumor staging criteria of American Joint committee on Cancer(AJCC), analysed the statistics of follow-up data about the tumor recurrence and metastasis of the patient.3.The En Vision immunohistochemical staining method was used to detect the expression of the three protein in the control group and experimental group.4. The Chi-square test method was used to analysed the different expression of the three protein between the experiment group and the control group.Compare the difference of gender and age proportions between the protein positive expression group and the negative group by the Fisher’s exact probability method and independent sample t-test,analysed the relations between expression of the three proteins and the tumor clinical stage、tumor recurrence and metastasis by the Spearman rank correlation way,in the CMM group.Results:There is an significant variation about the expression of protein Wipl、 Shh and Glil between the CMM group and the Pigmented Nevus group.In the CMM group,the negative immunostaining rate of protein Wipl is 32.2% (10/31), weakly positive expression rate of 9.6%(3/31), moderately positive expression rate of 32.2%(10/31),while,the strong positive rate is 25.8% (8/31);the negative immunostaining of protein Glil is 19.35 (6/31), weakly positive 12.9%(4/31),35.5%(11/31) moderately positive and 32.2%(10/31) strongly positive; Protein shh negative expression rate is 64.5%(20/31), weakly positive expression rate of 16.1%(5/31), moderately positive expression rate of 12.9%(4/31) and strong positive rate of 6.4%(2/31).In the pigmented nevus group, the negative expression rate of protein Wip1 is 100%(31/31);The negative expression rate of protein Glil is 90.3%(28/31),while, the weakly positive is 9.6%(3/31); The negative immunostaining rate of protein Shh is 90.3%(28/31), weakly positive of 9.6%(3/31). In the CMM group,the relationship between the expression of protein Wipl and the tumor clinical stage、tumor recurrence and metastasis is positive correlation,the correlation coefficient as follows:r (clinical stage correlation coefficient)= 0.61 (P<0.01), r (tumor recurrence correlation coefficient)= 0.41 (P= 0.02), r (tumor metastasis correlation coefficient)= 0.37 (P= 0.04), the correlation between the expression of protein Wipl and Glil is also positive,the correlation coefficient r is 0.55 (p<0.01); the relationship between the expression of protein Glil and the tumor clinical stage、tumor recurrence and metastasis is positive correlation, the correlation coefficient as follows:r (clinical stage correlation coefficient)= 0.61 (P<0.001), r (tumor recurrence correlation coefficient)=0.49(P<0.01),r (tumor metastasis correlation coefficient)= 0.45(P=0.01); the correlation between the expression of protein Shh and the tumor metastasis is also positive,the correlation coefficient is r=0.41 (p=0.02), but the correlation between the expression of protein Shh and the tumor clinical stage and recurrence is unclear, the coefficient have no statistically significant, in the compound nevus group, the expression of the protein Shh and Glil is in the same sample,follow-up date show that no patient has a tendency of pigmented nevus progression and recurrence.Conclusions:1.The positive expression rate of protein Wip1、Gli1 and Shh in the CMM group is significantly higher than in the Pigment Nevus group and the differences are statistically significant,suggest that the expression of protein Wipl or Glil may play an important role in the development and occurrence of the cutaneous malignant melanoma.2. In the CMM group, the stronger the expression of protein Wipl or Glil is,the higher the tumor clinical stage and the rate of tumor recurrence and metastasis is,this suggest that the protein of Wipl or Glil might can be used as the prognosis evaluation index of patient with CMM.3.In the CMM group,the correlation between the expression of protein Glil and Wip1 is positive,however,the the correlation between protein shh and Glil is unclear,that suggest the high expression of protein Glil is mainly regulated by the expression of protein Wipl in the CMM,the conclude may provide an guiding significance of the signaling pathway blockers in the study of CMM treatment. |
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