胃癌患者临床预后及病理因素与瘦素表达的相关性研究  

Correlation between expression of leptin and clinicopathologic factors and prognosis in human gastric cancer

作　　者：赵晓龙[1] 朱兆华[1] 黄开红[1] 徐国权[2] 闵军[2] 

机构地区：[1]中山大学附属第二医院消化科,广州510120 [2]中山大学附属第二医院普外科,广州510120

出　　处：《中华实验外科杂志》2004年第5期524-526,共3页Chinese Journal of Experimental Surgery

摘　　要：目的　探讨胃癌组织中瘦素 (Leptin)的表达与胃癌患者临床预后及病理因素的相关性。方法　 61例有 3年以上完整随访资料的胃癌术后患者 ,用免疫组织化学方法检测其手术标本石蜡切片的瘦素和血管内皮生长因子 (VEGF)表达。结果　分化好、有淋巴结转移及分期晚的肿瘤其瘦素表达阳性率显著高于与分化差、无淋巴结转移及分期早的肿瘤 (88.2 %、62 .8%、64 .2 %比48.9%、5 0 .0 %、47.4%,P <0 .0 5 )。在分化差的肿瘤组 ,瘦素组织学评分 <0 .5的生存率明显高于瘦素评分≥ 0 .5者 (P <0 .0 1)。Cox回归模型单因素分析结果显示 :浆膜浸润、肿瘤大小、远处转移、肿瘤分化程度、瘦素表达、淋巴转移、年龄、术后化疗为具有显著统计学意义的预后因素。结论　瘦素表达与胃癌的分化程度、分型、淋巴转移及临床分期有关 ,在分化差的肿瘤组瘦素表达越强其预后越差。Objective To study the relationship between the expression of leptin and clinicopathologic factors,as well as patient outcome.Methods Surgical specimens from sixty-one cases of gastric cancer followed up at least 3 years were investigated by immunohistochemical staining with anti-leptin and anti-VEGF antibodies.Results The positive rates of leptin in tumors with well-differentiation (Borrman type 1 and 2) and lymph node metastasis and in advanced stage (stageⅢ+Ⅳ) were significantly higher than those with poor-differentiation (Borrmann type 3 and 4) and without lymph node metastasis and in early stage (stageⅠ+Ⅱ) ( 88.2%,62.8%,64.2% vs 48.9%,50.0%,47.4% respectively, P < 0.05). The expression of leptin was significantly correlated with that of vascular endothelial growth factor ( r =0.169,P =0.000).In poorly differentiated group,overall survive rates for patients with a weak staining of leptin (histochemistry score<0.5) were signficantly higher than those with strong staining (histochemistry score≥0.5).The Cox proportional hazards model identified serosal involvement,tumor size,metastasis,tumor differentiation,leptin expression,lymph node metastasis,age and postoperative chemotherapy as the significantly prognostic factors.Conclusion The expression of leptin is signficantly associated with the tumor differentiation,Borrmann type,lymph node metastasis and stage in gastric cancer.In poorly differentiated gastric cancer,the more strongly the leptin expresses,the shorter survive time patients have.

关 键 词：胃癌 预后 病理因素 瘦素表达 相关性研究 瘦素 免疫组织化学 

分 类 号：R735.2[医药卫生—肿瘤]