胃腺癌临床病理及相关基因与预后  

Clinicopathological and related gene analysis in gastric adenocarcinoma and their correlation with prognosis

作　　者：倪型灏[1] 余传定[2] 许沈华[2] 周星明[3] 凌雨田[2] 张谷[1] 朱赤红[2] 刘祥麟[2] 

机构地区：[1]浙江省肿瘤医院病理科,310022 [2]浙江省肿瘤研究所 [3]浙江省肿瘤医院外科,310022

出　　处：《肿瘤研究与临床》2007年第10期695-697,700,共4页Cancer Research and Clinic

基　　金：浙江省医药卫生科研基金(2005A09)

摘　　要：目的进一步探索影响胃癌患者生存因素的有用指标。方法采用流式细胞仪(FCM)和免疫组织化学(IHC)技术分别检测98例胃腺癌 P-糖蛋白(P-gp)、CD_(44)、CD_(25)和 C-erbB-2、p16、p53抗体表达水平,并结合临床病理和随访资料进行相关性分析。结果以随访3年内死亡60例(其中失访11例按死亡计)为死亡组,生存3年以上38例(38.3%)为生存组。死亡组临床Ⅰ～Ⅱ期5例,Ⅲ～Ⅳ期55例;淋巴结无转移3例,转移57例;无瘤栓或累及神经21例,有瘤栓或累及神经39例;无浆膜浸润6例,有浆膜浸润54例。与相应生存组比较分别为21、17例;17、21例;26、12例;12、26例。均显示差异有统计学意义(P<0.01);死亡组肿瘤组织学分级中分化9例,低分化51例;瘤体≤5 cm 18例,>5 cm42例;肿瘤1个部位累及16例,2～3个部位累及44例;血型 A 10例,O 3l例与相应生存组比较分别为14、24例;21、17例;18、20例;14、13例,均显示差异有统计学意义(P<0.05)。而胃癌相关基因C-erbB-2、p16、p53、P-gp、CD_(44)、CD_(25)的表达在两组间比较均显示差异无统计学意义。结论胃癌患者临床分期、淋巴结转移、瘤体及神经受侵、浆膜浸润、瘤细胞分化程度、瘤体大小和累及范围是影响患者生存的重要因素。胃癌相关基因表达的确切意义和作用尚有待更多资料的研究。Objective To investigate the useful predictor of survival for patients with gastric adeno- carcinoma.Methods The expression of P-glycoprotein(P-gp),CD_(44),CD_(25)and C-erbB-2,p16 and p53 were evaluated and analyzed in 98 cases of gastric adenocarcinoma,using flow cytometry and immunohistochemical stains(IHC),to determine their prognostic impact on patients'survival.Results Sixty cases that died within 3 years were divided into death group, 38 cases that survived over 3 years were divided into survival group. The patients of death group were more liable to manifest clinical stage Ⅲ-Ⅳ(55/60), lymph node metastasis (57/60),lymphatic tumor emboli and/or neural involvement(39/60),serosa infiltration(54/60),poorly differentia- tion(51/60),>Scm in volume(42/60),multiple site involvement(44/60),blood type'O'(31/41),in comparison with those of survival group,and the difference was statistically significant.C-erbB-2,p16,p53,P-gp,CD_(44) and CD_(25)expression were not significantly different in these two groups. Conclusion The clinical stage, lymph node metastasis,lymphatic tumor emboli and/or neural involvement,infiltration depth,histological dif- ferentiation,tumor volume,involvement extension are important prognostic factors in patients with gastric can- cer,while the significance of cancer-related gene expression in gastric carcinomas needs to be studied further.

关 键 词：胃肿瘤 生存率 影响因素 流式细胞术 免疫组织化学 

分 类 号：R735.2[医药卫生—肿瘤]