影响胃肠间质瘤完全切除术后复发转移及预后的相关生物标志物研究  

Study on associated biomarkers influencing recurrence, metastasis and prognosis in patients with gastrointestinal stromal tumors after complete resection

作　　者：方洧靖[1] 张荣欣[1] 罗容珍[1] 区庆坚[1] 万德森[1] 潘志忠[1] 伍小军[1] 

机构地区：[1]中山大学肿瘤防治中心结直肠外科华南肿瘤学国家重点实验室,广州510060

出　　处：《中华胃肠外科杂志》2013年第3期242-246,共5页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的探讨影响胃肠间质瘤（GIST）完全切除术后复发转移及预后的生物标志物。方法收集1990年1月至2008年12月中山大学肿瘤防治中心148例完全切除术后的GIST标本．利用免疫组织化学技术、以组织芯片为载体，检测Ki-67、E-cadherin、MMP7、CD44、nm23、P53、Survivin、CyclinD1、COX．2和VEGF共10个生物指标，研究其表达与GIST完全切除术后复发转移和预后的关系。结果单因素预后分析（Log-rank检验）结果显示，Ki-67、E-cadherin、MMP7、CD44、P53和Survivin与GIST术后无瘤生存有关（均P〈0．05），Kj-67、E-cadherin、P53和Survivin与总体生存有关（均P〈0．05）。多因素预后分析（Cox回归模型）结果显示，Ki．67、CD44和P53是影响GIST完全切除术后复发转移的独立因素（均P〈0．05）；Ki-67是影响术后生存的独立因素（P〈0．05）。结论Ki．67、CD44和P53与GIST完全切除术后复发转移密切相关．Ki-67还能提示预后。Objective To explore the associated biomarkers influencing recurrence, metastasis and prognosis in patients with gastrointestinal stromal tumors （GIST） after complete resection. Methods Tumor tissue samples of 148 patients with GIST undergoing complete resection from January 1990 to December 2008 in Sun Yat-sen University Cancer Center were collected. The expressions of Ki-67, E-cadherin, MMP7, CD44, nm23, P53, survivin, Cyclin D1, COX-2, and VEGF in tumor tissue samples were detected by tissue microarray and immunohistochemistry （IHC）. The association of above factors expressions with recurrence, metastasis and prognosis was examined. Results Log-rank test showed that Ki-67, E-cadherin, MMP7, CD44, P53 and survivin were associated to disease-free duration after complete GIST resection（all P〈0.05）, and the Ki-67, E-cadherin, P53 and survivin were associated to overall survival （all P〈0.05）. Cox multivariate analysis revealed that disease-free survival was associated with Ki-67, CD44 and P53 （all P〈0.05）, and the overall survival was only associated with Ki-67（P〈0.05）. Conclusion Ki-67, CD44 and P53 are closely associated with recurrence and metastasis after complete GIST resection, and Ki-67 can predict the prognosis of GIST.

关 键 词：胃肠间质瘤 外科手术 生物标志物 肿瘤复发 预后 

分 类 号：R734.2[医药卫生—肿瘤]