中文摘要：

目的：探讨鼻咽癌间质组织中肿瘤相关纤维母细胞蛋白CD34和α-平滑肌肌动蛋白（α-smooth musde actin，α-SMA）与鼻咽癌侵袭、转移的关系。方法采用免疫组化SP法检测75例鼻咽癌间质组织（鼻咽癌组）和20例鼻咽黏膜慢性炎组织（对照组）中CD34和α-SMA的表达水平，分析其与鼻咽癌临床病理特征的关系。结果鼻咽癌组中CD34仅在血管内皮细胞中表达，阳性表达率为9.33%（7/75），在纤维母细胞中无表达；而对照组中CD34不仅在纤维母细胞中呈阳性表达，在小血管中也呈阳性表达，阳性表达率为85.00%（17/20），两组差异具有统计学意义（χ2=31.542，P〈0.01）。鼻咽癌组α-SMA的阳性表达率为81.33%（61/75），明显高于对照组的10.00%（2/20），差异具有统计学意义（χ2=51.263， P〈0.01）；对不同临床病理特征的鼻咽癌患者α-SMA的表达进行分析，发现α-SMA的表达与患者年龄、性别无关（P均〉0.05），而与鼻咽癌临床分期、T分期、淋巴结转移和远处转移有关（P均〈0.05）。结论与鼻咽黏膜慢性炎组织中的纤维母细胞相比，鼻咽癌间质组织中纤维母细胞发生表型改变，表现为CD34的表达缺失和α-SMA高表达。α-SMA与鼻咽癌浸润和转移密切相关。

英文摘要：

Objective To investigate the relationship of tumor-associated CD34 fibroblasts and α-smooth muscle actin（α-SMA）in the nasopharyngeal carcinoma interstitium with invasion and metastasis by nasopharyngeal carcinoma. Method Expression of CD34 and α-SMA was measured by immunohistochemistry in 75 patients with nasopharyngeal carcinoma and 20 patients with chronic inflammation of the nasopharyngeal mucosa.Expression levels were compared with clinicopathological features of nasopharyngeal carcinoma using the supervised two-step method. Result Of the 75 cancer patients,7 （9.33%）showed CD34 expression only in blood vessels and not in fibroblasts.In contrast,17 of 20 control patients （85.00%）showed CD34 expression not only in fibroblasts but also in small blood vessels of chronically inflamed tissue.These expression differences between the two groups were significant（χ2=31.542, P〈0.01）.The proportion of patients expressing α-SMA was significantly higher in the nasopharyngeal carcinoma group（61/75, 81.33%）than in the control group （2/20,10.00%;χ2=51.263,P〈0.01）. Correlation analysis of α-SMA expression with clinical and pathological features of nasopharyngeal carcinoma patients showed that the protein level was not related to age or gender（P〉0.05）, but it was associated with clinical stage,T stage,lymphatic metastasis and distant metastasis（P〈0.05）. Conclusion Fibroblasts in the n asopharyngeal carcinoma interstitium show phenotypic differences from the fibroblasts of chronically inflamed nasopharyngeal mucosa.These changes include lack of CD34 expression and overexpression of α-SMA.Expression levels ofα-SMA appear to be related to nasopharyngeal carcinoma metastasis.