目的：探讨Maspin蛋白在原发性胆管癌中的表达和意义及其与p53蛋白的关系。方法：用免疫组化法检测42例胆管癌连同癌旁组织及12例正常胆管组织中Maspin蛋白和p53蛋白的表达，分析两者与患者临床病理因素及预后的关系以及两者之间的关系。结果：Maspin蛋白与p53蛋白在胆管癌组织中阳性率均明显高于癌旁组织与正常胆管组织（均P<0.05）；Maspin蛋白表达与胆管癌淋巴结转移及远处转移有关，而p53蛋白表达与胆管癌病理分级、TNM分期、淋巴结转移以及远处转移有关（均P<0.05），但胆管癌中Maspin蛋白与p53蛋白表达无相关性（r=-0.329，P=0.144）。Maspin阳性表达患者术后生存期长于阴性表达患者（χ2=4.440，P=0.035），而p53阳性表达患者术后生存期短于阴性表达患者（χ2=8.231，P=0.004）。单因素与多因素Cox回归模型分析结果显示，Maspin蛋白是胆管癌患者预后的独立预测指标（HR=0.094，95% CI= 0.015~0.593，P=0.012）。结论：Maspin蛋白在胆管癌组织中表达增加，但其减少或缺失可能与患者不良临床病理特征及预后密切相关，且其作用机制可能与p53蛋白无关联。
Maspin expression in primary cholangiocarinoma tissue and its clinical significance
Objective: To investigate Maspin protein expression in cholangiocarinoma tissue as well as its clinical significance and relation with p53 protein. Methods: The Maspin and p53 protein expressions in 42 specimens of cholangiocarinoma tissues along with their adjacent tissues and 12 specimens of normal biliary duct tissues were detected by immunohistochemcal staining. The relations of the two proteins with clinicopathologic factors and prognosis of the patients and the relationship between the two proteins were analyzed. Results: The positive expression rates of both Maspin and p53 proteins in cholangiocarinoma tissue were significantly higher than those in cancer adjacent tissue and normal bile duct tissue (all P<0.05); the Maspin protein expression was significantly related to lymph node metastasis and distant metastasis of cholangiocarinoma, while p53 protein expression was significantly associated with the pathological grade, TNM stage, lymph node metastasis and distant metastasis of cholangiocarinoma, but there was no significant correlation between Maspin and p53 protein expression in cholangiocarinoma tissue (r=–0.329, P=0.144). The postoperative survival time in patients with positive Maspin expression was significantly longer than those with negative Maspin expression (χ2=4.440, P=0.035), while in patients with positive p53 expression was significantly shorter than those with negative p53 expression (χ2=8.231, P=0.004). Results of univariate and multivariate Cox regression analysis showed that Maspin protein expression was an independent prognostic index for holangiocarcinoma patients (HR=0.094, 95% CI=0.015–0.593, P=0.012). Conclusion: The Maspin protein expression is increased in cholangiocarcinoma tissue, but its deficiency or absence may closely be related to unfavorable clinicopathologic features and outcomes of the patients, and the mechanism of its action may not be associated with p53 protein.