肿瘤干细胞标志物CD24、CD44在胃癌组织中的共表达及患者临床病理参数和预后  

Co-expression of CD24 and CD44 in gastric carcinoma and its influence on clinicopathological parameters and prognosis

作　　者：韩方征[1] 张潇霖 董唯一 谢云亭 Han Fang-zheng;Zhang Xiao-lin;Dong Wei-yi;Xie Yun-ting(Department of Pathology,Heze Municipal Hospital,Heze 274031,Shandong Province,China;Department of Gastrointestinal Surgery,Heze Municipal Hospital,Heze 274031,Shandong Province,China;Department of Pathology,Shanxian Haijiya Hospital,HYGEIA Medical Services Group,Heze 274300,Shandong Province,China)

机构地区：[1]菏泽市立医院病理科,山东省菏泽市274031 [2]菏泽市立医院胃肠外科,山东省菏泽市274031 [3]上海海吉亚医疗集团菏泽市单县海吉亚医院病理科,山东省菏泽市274300

出　　处：《中国组织工程研究》2018年第29期4625-4630,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:国内外研究显示CD24、CD44表达与胃癌的疾病进展、临床病理参数及预后可能存在密切关系。目的:探讨胃癌组织中干细胞标志物CD24、CD44共表达情况及对患者临床病理参数、预后的影响。方法:收集2006年4月至2012年4月在菏泽市立医院胃肠外科行手术治疗的胃癌患者的临床资料。采用免疫组织化学法检测癌组织、癌旁组织、正常胃组织中CD24、CD44蛋白表达情况,记录患者临床病理参数并随访。统计分析CD24、CD44双阳性表达与患者临床病理参数间的关系及对患者预后的影响。结果与结论:(1)在180例患者中,CD24阳性率为57.5%(92/180),其中低表达54例,高表达38例;CD44阳性率为49.3%(79/180),其中低表达48例,高表达31例。二者的共表达率为24.3%(39/180),双阴性率为30.0%(48/180);(2)与癌组织相比,正常胃组织和癌旁组织CD24、CD44的阳性率均较低,且差异有显著性意义(P<0.001);(3)单因素分析结果显示,CD24、CD44在胃癌组织中的共表达与胃癌组织大小、T分期、N分期、脉管浸润相关(P<0.05),但与患者年龄、性别、肿瘤部位、WHO病理分型、Lauren分型、M分期无关(P>0.05)。多因素分析结果发现T分期、N分期是影响CD24、CD44在胃癌组织中共表达的独立性危险因素;(4)Spearman等级相关分析结果显示,CD24和CD44的表达强度之间不存在相关关系(r=0.020,P=0.795);(5)180例患者,失访17例,失访率为9.4%。5年内死亡87例,CD24单阳组53例患者,死亡21例;CD44单阳组40例患者,死亡23例;双阴组48例患者,死亡13例,双阳组39例患者,死亡30例。Log-rank统计检验显示,4组患者的生存率差异有显著性意义(χ~2=21.72,P<0.001),CD24(+)CD44(+)患者预后最差;(6)结果表明,CD24、CD44在胃癌中有较高的阳性率,且与患者分期密切相关。二者的共表达是患者预后不良的强烈信号。BACKGROUND:Studies have shown that the expression of CD24 and CD44 may be closely related to the disease progression,clinicopathological parameters and prognosis of gastric carcinoma.OBJECTIVE:To investigate the expression of CD24 and CD44 in gastric carcinoma and its influence on clinicopathological parameters and prognosis.METHODS:The clinical data of patients undergoing surgical resection of gastric carcinoma in Heze Municipal Hospital from April 2006 to April 2012 were collected.The expression of CD24 and CD44 protein in cancer tissues,paracancerous tissues and normal tissues from resected specimens was detected by immunohistochemistry.The relationship between the expressions of CD24 and CD44,clinicopathological parameters and prognosis of the patients was analyzed.RESULTS AND CONCLUSION:(1)Among 180 patients,the positive rate of CD24 was 57.5%(92/180),which was lowly expressed in 54 cases and highly expressed in 38 cases;the positive rate of CD44 was 49.3%(79/180),which was lowly expressed in 48 cases and highly expressed in 31 cases.The co-expression rate was 24.3%(39/180)and the double negative rate was 30.0%(48/180).(2)Compared with cancer tissues,the positive rates of CD24 and CD44 in normal gastric tissues and paracancerous tissues were significantly lower(P<0.001).(3)Univariate analysis showed that the co-expression of CD24 and CD44 in gastric cancer tissues was related to the size of gastric carcinoma,T staging,N staging,vascular invasion(P<0.05),but not related to age,sex,tumor site,WHO pathological classification,Lauren classification and M staging(P>0.05).Multivariate analysis showed that T staging and N staging were independent risk factors affecting the expression of CD24 and CD44 in gastric cancer tissues.(4)Spearman rank correlation analysis showed no correlation between the expression intensity of CD24 and CD44(r=0.020,P=0.795).(5)Seventeen of 180 cases were lost to follow-up,and the loss rate was 9.4%.Eighty-seven patients died within 5 years.Twenty-one of 53 patients in CD24 single-positive

关 键 词：胃肿瘤 CD24 CD44 肿瘤干细胞 危险因素 预后 干细胞 胃肿瘤 抗原 CD24 抗原 CD44 肿瘤干细胞 组织工程 

分 类 号：R394.2[医药卫生—医学遗传学]