胃癌中EGFR的表达与临床、病理、预后及多药耐药蛋白P170、TopoⅡ、GST-π表达的关系  

EGFR expression and its correlation with P170,TopoⅡ and GST-π in gastric carcinoma and their relationship with clinicopathological data and prognosis

作　　者：张帆[1] 杨兴无[1] 李连宏[2] 孙闯[3] 王波[2] 陈鑫[1] 王乃玉[4] 于晓棠[2] 

机构地区：[1]大连医科大学附属第二医院普外科,大连116027 [2]大连医科大学病理学与法医学教研室,大连116044 [3]大连医科大学附属第二医院影像科,大连116027 [4]大连医科大学附属第二医院病理科,大连116027

出　　处：《临床与实验病理学杂志》2013年第10期1060-1064,1068,共6页Chinese Journal of Clinical and Experimental Pathology

基　　金：辽宁省教育厅科学研究一般项目(L2011157)

摘　　要：目的探讨表皮生长因子受体(epidermal growth factor receptor,EGFR)在胃癌中的表达及其与临床病理参数、预后及多药耐药蛋白P-糖蛋白(P-glycoprotein,P170)、DNA拓扑异构酶Ⅱ(topoisomeraseⅡ,TopoⅡ)和谷胱苷肽-S转移酶(glutathione S-transferase-π,GST-π)表达的关系及意义。方法采用免疫组化ABC法检测160例胃癌组织中EGFR、P170、TopoⅡ及GST-π的表达以及EGFR在20例癌旁正常组织中的表达。研究EGFR在胃癌及癌旁正常黏膜中的表达差异,同时分析各因子表达与患者临床病理资料、预后的关系。结果 EGFR在160例胃癌标本中89例阳性,在20例癌旁正常黏膜中2例弱阳性,其在胃癌中的表达明显高于癌旁正常对照组(P<0.05)。EGFR与TopoⅡ的表达呈正相关(P<0.05)。EGFR表达与肿瘤的远处转移相关(P<0.05)。P170表达与肿瘤直径、淋巴结转移、远处转移及TNM分期相关(P<0.05)。GST-π表达与肿瘤远处转移及TNM分期相关(P<0.05)。TopoⅡ表达与病理分级、侵袭深度、远处转移及TNM分期相关(P<0.05)。单因素分析发现患者年龄、肿瘤直径、肿瘤部位、病理分级、侵袭深度、淋巴转移、远处转移、TNM分期、EGFR、TopoⅡ、GST-π均与预后有关(P<0.05)。Cox风险模型多因素分析发现病理分级、TNM分期、EGFR是影响胃癌预后的独立因素(P<0.05)。结论 EGFR在胃癌中高表达,与多药耐药蛋白TopoⅡ表达相关,是预测肿瘤预后的独立因素,可能参与化疗耐药。针对EGFR的分子靶向治疗可能使化疗或辅助化疗耐药,EGFR阳性胃癌患者获得较好的疗效。Purpose To evaluate the expression of epidermal growth factor receptor （EGFR） in gastric adenocarcinoma and its possi- ble relationship with clinicopathologic parameters, prognosis and correlation with the expression of P-glycoprotein （P170） , topoisomer- ase Ⅱ （Topo Ⅱ ）, and glutathione S-transferase-π （GST-π）. Methods The expression of EGFR, P170, TopoⅡ and GST-π in 160 cases of gastroadenocarcinoma was detected by immunohistochemistry. The expression of EGFR in 20 cases of relatively normal tissue surrounding cancer were detected by immunohistochemistry. Patients were followed up for more than three years. The relationships be- tween the expression of EGFR, P170, TopoⅡ , GST-π and the clinicopathologic parameters were analyzed. The relationships between these parameters and prognosis of patients were also evaluated. Results EGFR expression in gastric carcinoma was significantly higher than the surrounding tissue. 89 cases of gastric cancer were positive for EGFR. Only 2 surrounding normal tissue showed weak positive for EGFR. There were positive correlation between the expression of P170 and GST-π, Topo Ⅱ and EGFR （P 〈 0.05 ）. The expression of EGFR was related to the distal metastasis （P 〈 0. 05 ）. The intensity of P170 was related to the diameter of tumor, lymphatic metas- tasis, distant metastasis and TNM stage （P 〈 0. 05）. The expression of GST-π was associated to distant metastasis and TNM stage （ P 〈 0. 05）. The expression of Topo Ⅱ was related to the grade, distant metastasis, depth of invasion and TNM stage （P 〈 0. 05 ）. Univa- riate analysis showed that age, tumor diameter, tumor site, histological type, depth infiltration, lymphatic metastasis, distance metas- tasis, TNM stage and the expression of EGFR, ToPo Ⅱ , GST-π were related to the prognosis of gastric carcinoma （P 〈 0. 05 ）. Multi- variate Cox model analysis showed that histological type, TNM stage and EGFR were the independent prognostic factors for the patients （P �

关 键 词：胃肿瘤 表皮生长因子受体 P-糖蛋白 DNA拓扑异构酶Ⅱ 谷胱苷肽-S转移酶 预后 

分 类 号：R735.2[医药卫生—肿瘤]