贲门癌与胃窦部癌的临床病理指标及免疫组化指标差异性分析  

Differential expression of cal markers between cardiac carcinoma and carcinoma in antrum of stomach and correlation thereof with clinicopathological factors

作　　者：叶延伟[1] 师英强[1] 王春萌[1] 李百周[2] 祝蕾[2] 

机构地区：[1]复旦大学附属肿瘤医院复日大学上海医学院肿瘤学系腹部外科,200032 [2]复旦大学附属肿瘤医院复日大学上海医学院病理科,200032

出　　处：《中华医学杂志》2009年第14期962-966,共5页National Medical Journal of China

摘　　要：目的分析常用免疫组化指标在贲门癌与胃窦部癌中的差异性表达及与临床病理资料的相关性。方法从2005年复旦大学附属肿瘤医院胃癌手术患者的石蜡包埋标本中，随机抽取临床病理资料完整的标本211例，包括贲门癌标本110例，胃窦部癌标本101例。通过免疫组化Envision两步法，检测以上标本常见免疫组化指标的表达情况。通过SPSS12．0软件对临床病理资料及免疫组化结果建立数据库。结果贲门癌与胃窦部癌相比，临床病理分期、分化程度、浸润深度、淋巴结转移情况等差异均有统计学意义（均P〈0．05）。P21、人类表皮生长因子受体2（Her-2／Neu）、谷胱甘肽S转肽酶（GST-π）在贲门癌中的阳性表达率分别为80．0％（88／110）、30．9％（34／110）、92．7％（76／82），而在胃窦部癌中的阳性表达率分别为67．0％（65／97）、16．7％（16／96）、74．5％（41／55），差异均有统计学意义（P=0．034、0．017、0．003）。在贲门癌标本中，P21与P27、上皮生长因子受体（ECFR）呈正相关；P27与EGFR、拓扑异构酶Ⅱ（TOPOⅡ）之间亦呈正相关；而GST-IT与TOPOⅡ亦呈正相关（r=0．255，P=0．021）。而在胃窦部癌标本中，GST-π与EGFR、TOPOⅡ、Her-2／Neu均呈正相关，与增殖细胞核抗原（PCNA）呈负相关；P27与P53之间亦存在正相关（r=0．275，P=0．042）。结论临床病理多项指标和P21、Her-2／Neu、GST-π等分子标记物在贲门癌和胃窦部癌中存在差异，提示不同部位的胃癌发生发展过程中可能存在不同的分子机制。Objective To study the differences in expression of several common immunohistochemical markers ： epidermal growth factor receptor （ EGFR）, topoisomerase Ⅱ （ TOPO Ⅱ ）, glutathione S-transferase π（ GST-π）, proliferation cell nuclear antigen （ PCNA）, Her-2/Neu, P27, P21, and P53, between cardiac carcinoma and carcinoma in antrum of stomach and the correlation thereof with clinicopathological factors. Methods 211 paraffin-embedded tissue samples of gastric cancer were randomly chosen from the patients of cardium and stomach operated in 2005, including 110 cases of cardiac carcinoma and 101 cases of carcinoma in antrum of stomach. Immunohistochemical Envision two step method was used to detect the expression of the above mentioned markers. Results Compared to the cardiac carcinoma, the carcinoma in antrum of stomach showed higher rate of clinicopathological staging was significantly higher, degree of differentiation lower, invasion deeper, and degree of lymph node metastasis higher （ all P 〈 0.05 ）. The expression rates of P21, Her-2/Nen, and GST-π of the cardiac carcinoma group were 80.0% （ 88/ 110）, 30. 9% （34/110）, and 92.7% （76/82） respectively, all significantly higher than those of the carcinoma in antrum of stomach group [ 67. 0% （65/97）, 16. 7% （16/96）, and 74. 5% （41/55） respectively, P = 0.034, 0. 017, and 0. 003 respectively]. In the cardiac carcinoma,P21 expression was positively correlated with the expression of P27 and EGFR, the P27 expression was positively correlated with the expression of EGFR and TOPO Ⅱ , and the GST-π expression was positively correlated with the TOPO Ⅱ expression （r = 0.255 ,P = 0. 021 ）. In the antrum of stomach carcinoma, GST-π expression was positively correlated with the expression of EGFR, TOPO Ⅱ , and Her-2/Neu,however,it was negatively correlated with the expression of PCNA, and the P27 expression was positively correlated with the P53 expression （r=0.275,P = 0.042）. Conelusion Different molecular mechani

关 键 词：胃肿瘤 幽门窦 免疫组织化学 病理学 临床 

分 类 号：R686[医药卫生—骨科学]