胃癌原发灶中Snail和CXCR4的表达及其与临床病理特征和预后的关系  

Expression of Snail and CXCR4 in primary iesion and ,ts rela-tionship with clinicopathological profiles and prognosis in gastric cancer

作　　者：陈李骏[1] 蔡成[1] 俞继卫[1] 吴巨钢[1] 陆瑞祺[1] 姜波健[1] 

机构地区：[1]上海交通大学医学院附属第三人民医院普外一科,上海201999

出　　处：《国际外科学杂志》2013年第7期442-447,F0003,共7页International Journal of Surgery

基　　金：国家自然科学基金项目（No.81101850）;上海市卫生局重点课题（No.2010018）

摘　　要：目的研究趋化因子受体4（CXCR4）与上皮间质转化（EMT）相关因子Snail表达与胃癌临床病理特征、预后的关系。方法利用免疫组化方法检测50例胃癌组织中CXCR4和Snail的表达，分析Snail和CXCR4表达与胃癌患者的临床病理学指标的关系，Spearman等级相关方法分析Snail和CXCR4表达的关系，Kaplan—Meier方法分析CXCR4和Snail表达与胃癌患者生存的关系。结果Snail和CXCR4表达阳性率各为62％（31／50）和58％（29／50）；肿瘤越大、组织分化越差、有血管浸润、淋巴管浸润、存在淋巴结转移和浸润越深Snail阳性表达越高。肿瘤越大、有血管浸润、有淋巴管浸润、存在淋巴结转移和浸润越深，则CXCR4阳性表达越高。Spearman相关分析表明，Snail与CX—CR4的表达呈正相关（r=0．330，P=0．014）。Snail和CXCR4共同阳性表达为患者术后生存的独立预后因素（P=0．001）。结论CXCR4和Snail共同表达为胃癌患者独立预后因子，两者之间可能互相联系促进胃癌的侵袭和转移，通过靶向CXCR4和EMT相关因子或能干预胃癌的转移与复发。Objective To investigate the clinicopathologic characters and prognostic value of epithelial mesenehymal transition （EMT） related proteins Snail and ehemokine receptors 4（ CXCR4 ） in gastric canc- er. Methods The expressions of Snail and CXCR4 in the gastric tissues of 50 patients with gastric cancer were detected by Immunohistochemistry. The relation between the expressions of Snail and CXCR4 and the clinicopathologie characters were analyzed. 3he relative relationship between Snail expression and CXCR4 ex- pression were identified by Spearman method. The correlation between the expressions of Snail and CXCR4 with the survival was analyzed by Kaplan-Meier method. Results The expression of Snail and CXCR4 ex- pression were positive in 31 of 50 cases （62%） and 29 of 50 cases （58%） respectively. The expression levels of Snail and CXCR4 in the gastric cancer patients with diameter more than 5 cm, worse tissue differen- tiation, vascular invasion, lymphatic vessel invasion,lymph nodes metastasis, and T3 ＋ T4 staging were sig-nificantly higher than those in the patients with diameter less than 5 cm,without vascular invasion,lymphatic vessel invasion,lymph nodes metastasis, and T1 ＋ T2 staging （ P 〈 0.05 ）. The Expression of Snail and CX- CR4 was positively Correlated（ r = 0. 330, P = 0. 014）. The co-expression of Snail and CXCR4 was signifi- cantly associated with poorer prognosis and was applied as an independent prognostic factor for gastric cancer （P = 0. 001 ）. Conclusions The co-expression of Snail and CXCR4 was the independent prognostic factor for gastric cancer. The combining effect of EMT and CXCR4 may promote the progressions and metastasis of gastric cancer. Therefore, it may be of an effective way for the metastasis of gastric cancer to adjust these targets of the Snail and CXCR4.

关 键 词：胃 新生物 癌 上皮间质转化 CXCR4 预后 

分 类 号：R735.2[医药卫生—肿瘤]