早幼粒细胞白血病蛋白的缺失对胃癌和结直肠癌预后的影响  

Effect of Promyelocytic Leukemia Protein Deficiency on Prognosis of Gastric and Colorectal Cancers

作　　者：林生力[1] 陈艺樟[2] 易拓[1] 董天庚[1] 洪信强[1] 胡健卫[1] 张震[1] 牛伟新[1] 

机构地区：[1]复旦大学附属中山医院普外科,上海200032 [2]第二军医大学卫生勤务学系,上海200433

出　　处：《中国临床医学》2015年第5期637-642,共6页Chinese Journal of Clinical Medicine

基　　金：上海市卫生和计划生育委员会重点资助项目(编号:20114005)

摘　　要：目的:研究早幼粒细胞白血病蛋白(promyelocytic leukemia protein,PML)与胃肠肿瘤的关系,并探讨PML与表皮生长因子受体(epidermal growth factor receptor,EGFR)、血管内皮生长因子(vascular endothelial growth factor,VEGF)间的关系。方法:采用免疫组化法检测胃癌和结直肠癌中PML、EGFR、VEGF的表达情况,并分析它们与肿瘤侵袭、淋巴结转移、TNM分期以及患者生存率之间的关系。结果:PML在胃肠癌旁正常组织中均呈阳性表达,其在胃癌组织中的缺失率为33.8%(54/160),在肠癌组织中的缺失率为38.1%(64/168)。胃癌组织中PML缺失与肿瘤侵犯程度(P<0.001)、淋巴结转移(P=0.018)以及TNM分期(P<0.001)正相关;PML阳性患者较PML阴性患者生存期长(52个月比39个月,P<0.001);年龄、PML表达与否以及TNM分期情况是影响胃癌预后的独立危险因素。结直肠癌组织中PML缺失与TNM分期(P=0.012)正相关,PML阳性患者较PML阴性患者生存期长(53个月比44个月,P=0.001);结直肠癌组织中EGFR阳性表达与肿瘤组织侵犯程度(P<0.001)、淋巴结转移(P<0.001)以及TNM分期(P<0.001)正相关;PML是否缺失、TNM分期情况以及EGFR表达与否是影响结直肠癌患者预后的独立危险因素。PML表达与EGFR和VEGF的表达负相关(P<0.05)。结论:PML缺失可能通过上调EGFR和VEGF的表达而促进胃癌和结直肠癌的进展;PML缺失与胃癌和结直肠癌患者的预后相关。Objective：To study the relation between promyelocytic leukemia protein（PML）and gastric and colorectal cancers,and explore the relation between PML and epidermal growth factor receptor（EGFR）and vascular endothelial growth factor（VEGF）.Methods：The expression situations of PML,EGFR,and VEGF in gastric and colorectal cancer were detected by immunohistochemistry,and their relations with tumor invasions,lymph node metastases,TNM stages and patients＇ survival were analyzed.Results：PML was positively expressed in normal tissue adjacent to gastrointestinal cancer.The rate of PML deficiency was 33.8%（54/160）in gastric cancer tissue,while it was 38.1%（64/168）in colorectal cancer tissue.PML deficiency in gastric cancer tissue was positively correlated with gastric wall invasion（P〈0.001）,lymph node metastases（P=0.018）and TNM stage（P〈0.001）,and the survival period of patients with positive PML was longer than that of patients with negative PML（52 months vs 39 months,P〈0.001）.Age,PML deficiency and TNM stage were the independent risk factors of gastric cancer prognosis.PML deficiency in colorectal cancer tissue was positively correlated with TNM stage（P=0.012）,and the survival period of patients with positive PML was longer than that of patients with negative PML（53 months vs 44 months,P=0.001）.The positive expression of EGFR was positively correlated with colorectal wall invasion（P〈0.001）,lymph node metastases（P〈0.001）and TNM stage（P〈0.001）.PML deficiency,TNM stage and EGFR expression were the independent risk factors of colorectal cancer prognosis.PML expression was negatively correlated with EGFR and VEGF expression（P〈0.05）.Conclusions：PML deficiency may promote the progression of gastric and colorectal cancer by up-regulating the expression of EGFR and VEGF.PML deficiency is correlated with prognosis of gastric and colorectal cancer patients.

关 键 词：早幼粒细胞白血病蛋白 胃癌 结直肠癌 表皮生长因子受体 血管内皮生长因子 

分 类 号：R735.2[医药卫生—肿瘤]