微卫星不稳定性与胃癌预后的研究  

Study of relationship between microsatellite instability and prognosis of gastric cancer.

作　　者：时俊[1] 林庚金[1] 徐三荣[1] 关明[1] 

机构地区：[1]复旦大学附属华山医院消化科,上海200040

出　　处：《中国综合临床》2004年第7期626-628,共3页Clinical Medicine of China

摘　　要：目的　探讨微卫星不稳定性 (MSI)与胃癌预后的关系。方法　采用聚合酶链 简单序列长度多态性 (PCR SSCP)的方法对胃癌MSI进行检测 ,明确MSI与临床病理参数 (肿瘤大小、部位、分化、Lauren′s分型、分期 )之间的关系。其次 ,应用图像细胞仪 (ICM)对胃癌组织进行细胞核DNA含量测定 ,比较MSI阳性组与MSI阴性组之间DNA含量的差异。平均DNA含量及细胞增殖指数作为观察指标。结果　 5 1例胃癌MSI总阳性率为 4 3.1% (2 2 /5 1)。中 高分化腺癌MSI检出率 (6 5 .2 % )显著高于低分化腺癌 (2 5 .0 % ) (P <0 .0 1) ;肠型胃癌MSI阳性率 (5 7.7% )高于弥漫型胃癌 (2 5 .0 % ) (P <0 .0 5 )。MSI阳性组平均DNA含量、细胞增殖指数均显著低于MSI阴性组 (10 .0 16 16± 0 .96 6 77VS 16 .3314 4± 2 .972 5 3& 0 .390 6 6± 0 .0 890 1VS 0 .7395 5± 0 .10 4 33,P <0 .0 1)。Objective To investigate the relationship between microsatellite instability(MSI) and prognosis of gastric cancer. Methods MSI was examined in 51 gastric cancer specimens which were obtained endoscopically and resected during surgery using PCR-SSCP method to determine the relationship between MSI and clinical pathological parameters(including tumor size, site, differentiation, Lauren′s typing and staging).DNA content of gastric cancer cell was analyzed by image cytometry(ICM), which difference between MSI positive group and MSI negative group was compared.Average DNA content and cell proliferation index were taken as observation index. Results MSI was detected in 22/51 cases of gastric cancer(43.1%). The incidence of MSI in well differentiated gastric cancer(65.2%) was much higher than that in poorly differentiated gastric cancer(25.0%, P<0.01). The positive rate of MSI in intestinal type of gastric cancer(57.7%) was higher than that in diffused type(25.0%, P<0.05). The DNA content and cell proliferation index of MSI positive group were much lower than that of MSI negative group(10.01616±0.96677 vs 16.33144±2.97253 & 0.39066±0.08901 vs 0.73955±0.10433,P<0.01). Conclusion MSI may mean a relatively better prognosis of gastric cancer.

关 键 词：胃肿瘤 微卫星不稳定性 细胞核DNA含量 

分 类 号：R735.2[医药卫生—肿瘤]