胃癌组织中新型微卫星不稳定性检测及其与人表皮生长因子受体2、P53关系的研究  

Evaluation of a new detection method for microsatellite instability and its relationship with the expression of human epidermal growth factor receptor 2 and P53 in gastric cancer tissues

作　　者：廖子中 邱子奕 张吉 陈娟[1] 刘崇梅[3] 余飞跃[1] 邱荣元[1] Liao Zizhong;Qiu Ziyi;Zhang Ji;Cheng Juan;Liu Chongmei;Yu Feiyue;Qiu Rongyuan(Department of Gastroenterology,Yueyang Hospital Affiliated to Hunan Normal University,Yueyang 414000,China;The Fifth Clinical Medical College,Xinjiang Medical University,Wulum uqi 830000,China;Department of Pathology,Yue yang Hospital Affiliated to Hunan Normal University,Yueyang 414000,China)

机构地区：[1]湖南师范大学附属岳阳医院消化内科,岳阳414000 [2]新疆医科大学第五临床医学院,乌鲁木齐830000 [3]湖南师范大学附属岳阳医院病理科,岳阳414000

出　　处：《中华老年医学杂志》2022年第2期173-178,共6页Chinese Journal of Geriatrics

摘　　要：目的研究胃癌组织人表皮生长因子受体2(HER2)、肿瘤抑制蛋白质P53的表达及其与微卫星不稳定性(MSI)的关系。方法选取湖南师范大学附属岳阳医院2018年1月至2020年10月确诊为胃癌的103例患者作为研究对象.应用免疫组织化学(IHC)法检测患者胃癌及癌旁正常组织HER2、P53,错配修复蛋白表达情况,应用多重荧光PCR(Idylla)检测7个位点的MSI状态。结果本研究中,103例胃癌患者中.IHC法显示微卫星稳定(MSS)患者有77例(74.8%),MSI患者有26例(25.2%),PCR法显示MSS患者有77例,MSI患者有26例。MSI HER2低表达率高于HER2高表达率,MSI HER2低表达率MSS HER2低表达率(P<0.05)。MSI P53低表达率高于P53高表达率,MSI P53低表达率低于MSS低P53表达率(P<0.05)。结论胃癌发生过程中可能存在MSI状态;胃癌的MSI状态可能伴随HER2.P53表达降低,胃癌组织中HER2及P53的表达与MSI状态存在互斥的关系,提示MSI的致癌机制可能与HER2及P53具有较大的差异性。MSI型检测对于治疗药物选择及预后判断都有较强的指导意义。Objective To investigate the expression of human epidermal growth factor receptor 2(HER2)and P53 and their relationship with microsatellite instability(MSI)in gastric cancer tissues.Methods A total of 103 patients diagnosed with gastric cancer between January 2018 and October 2020 at Yueyang Hospital were enrolled in this study.HER2,P53 and mismatch repair proteins in gastric cancer tissues were detected with immunohistochemica(IHC)methods,and MSI screening was conducted at 7 sites with a new Idylla MSI(multiple fluorescent PCR)method.Results Of 103 gastric cancer patients in this study,77(74.8%)showed microsatellite stability(MSS)and 26(25.2%)showed MIS via IHC,and PCR also detected 77 MSS cases and 26 MSI cases.In MSI,there was more low HER2 expression than high HER2 expression,and the rate of low HER2 expression in MSI was higher than the rate of high HER2 expression in MSI(P<0.05).Also in MSI,there was more low P53 expression than high P53 expression,and the rate of low P53 expression in MSI was higher than the rate of high expression in MSI(P<C0.05).Conclusions MSS may exist in the process of gastric carcinogenesis and in gastric cancer it may be accompanied by low expression of HER2 and p53 in cancer tissues.There may be a mutually exclusive relationship between MSI and expressions of HER2 and p53,suggesting that carcinogenic mechanisms involving MSI may be very different from those involving HER2 and p53.MSI detection is very valuable in guiding treatment drug selection and prognosis assessment.

关 键 词：胃肿瘤 微卫星不稳定性 表皮生长因子 肿瘤抑制蛋白质P53 

分 类 号：R735.2[医药卫生—肿瘤]