肠化生皮下肌成纤维细胞标志物在肠型胃癌中的表达及其与Ki-67表达的相关性分析  

Expression of intestinal metaplasia myofibroblast markers in intestinal gastric cancer and its correlation with Ki-67

作　　者：翟真真[1] 王乐[1] 尚淑平[1] 刘娜[1] 周连泉[1] ZHAI Zhen-zhen;WANG Le;SHANG Shu-ping;LIU Na;ZHOU Lian-quan(Department of Gastroenterology,Dezhou People＇s Hospital,Shandong,Dezhou 253014,China)

机构地区：[1]德州市人民医院消化内科,山东德州253014

出　　处：《中国医学前沿杂志（电子版）》2018年第7期80-83,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：山东省医药卫生科技发展计划项目(2016WS0069)

摘　　要：目的探讨肠型胃癌与癌前病变患者病变处胃黏膜肌成纤维细胞内转化生长因子-β(transforming growth factor-β,TGF-β)、α-平滑肌肌动蛋白(α-smooth muscle actin,α-SMA)与Ki-67表达的相关性。方法选取2016年9月至2017年2月于本院行电子胃镜和病理组织检查的102例患者,收集并保存其资料,将其中67例确诊为肠型胃癌患者纳入观察组,35例癌前病变患者纳入对照组。采用免疫组织化学法检测肠化生皮下肌成纤维细胞内TGF-β、α-SMA及Ki-67的表达水平,并分析其相关性。结果观察组患者肌成纤维细胞内TGF-β、α-SMA、Ki-67阳性表达例数均显著多于对照组(P_均<0.05)。观察组中瘤体大小≥5 cm、未侵及浆膜层、淋巴结未转移及TNM分期Ⅰ~Ⅱ期患者的肌成纤维细胞中TGF-β、α-SMA及Ki-67阳性表达例数均显著增高(P_均<0.05)。TGF-β、α-SMA阳性表达在不同分化程度的肌成纤维细胞之间无显著差异(P均>0.05),低分化癌变细胞中Ki-67阳性表达显著增加(P<0.05)。Ki-67与TGF-β、α-SMA的相关性值分别为0.626、0.754(P_均<0.05),TGF-β、α-SMA表达与Ki-67表达均呈正相关。结论在胃黏膜细胞由良性发展为恶性癌细胞过程中,肠化生引起皮下肌成纤维细胞分泌的TGF-β、α-SMA与Ki-67表达均呈正相关,对临床进行肠型胃癌的早期预防具有一定参考价值。Objective To explore the correlation between transforming growth factor-β（TGF-β）, α-smooth muscle actin（α-SMA） and Ki-67 expression in patients with intestinal-type gastric cancer or precancerous lesions. Method 102 cases of patients who underwent electronic gastroscopy and pathological examination in our hospital from September 2016 to February 2017 were selected and their data were collected. Among them, 67 cases diagnosed as intestinal-type gastric cancer were included in observation group, and 35 cases with precancerous lesions were included in control group. Immunohistochemistry was used to detect the expression levels of TGF-β, α-SMA and Ki-67 in intestinal metaplasia myofibroblasts, and their correlation was analyzed. Result The quantities of positive expression of TGF-β, α-SMA and Ki-67 in myofibroblasts in observation group were significantly higher than those in control group（Pall〈0.05）. The quantities of positive expression of TGF-β, α-SMA and Ki-67 myofibroblasts of patients with tumor volume ≥ 5 cm, no invasion to serosal layer, no lymphatic metastasis and stage Ⅰ ~ Ⅱ of TNM were significantly increased in observation group（Pall〈0.05）. There was no significant difference in the positive expression of TGF-β and α-SMA among myofibroblasts with different differentiation degrees（Pall〈0.05）, and the positive expression of Ki-67 in poorly differentiated cancer cells was increased significantly（P〈0.05）. The correlation values between Ki-67 and TGF-β, α-SMA were 0.626 and 0.754 respectively（Pall〈0.05）, and the expression of TGF-βand α-SMA were positively correlated with Ki-67. Conclusion In the process of gastric mucosal cells from benign to malignant cancer cells, the TGF-β and α-SMA secreted by myofibroblasts due to intestinal metaplasia are positively related to Ki-67, which is certain reference value for early prevention of clinical entry into intestinal type gastric cancer.

关 键 词：肠型胃癌 癌前病变 转化生长因子-Β Α-平滑肌肌动蛋白 Ki-67 

分 类 号：R735.2[医药卫生—肿瘤]