摘要
目的探讨胃癌组织中生存素、P53表达与胃癌临床病理特征和生物学预后的相关性及意义。方法将100例术前无放、化疗史的胃癌患者手术标本和30例对照组胃黏膜制成组织芯片,取样针直径2.0 mm。免疫组化法检测生存素、P53在胃癌中的表达,原位末端标记法(TUNEL 法)检测细胞凋亡指数(AI),分析其相互关系及与胃癌临床病理特征的相关性,对随访14个月～13年的47例患者作生存分析。结果 100例胃癌和30例对照组胃黏膜共获得2个组织芯片蜡块,分别含114和116个位点。在胃癌组织芯片中,生存素和 P53阳性表达为78%和52%,而对照组胃黏膜几乎无表达(P<0.01),生存素的阳性率与胃癌组织分化、淋巴结转移、血管神经(BV/N)侵犯及临床分期有关(P<0.05);生存素阳性组胃癌细胞 AI(3.2±1.0)明显低于阴性组(4.0±1.1,P<0.01)。P53表达在胃癌不同组织分化、临床分期和 BV/N 侵犯、淋巴结转移中差异均无统计学意义(P>0.05),胃癌 P53表达与AI 无关(阳性组:3.5±1.2,阴性组:3.2±1.0;P>0.05)。在有随访结果的47例胃癌中,单因素 Cox 分析显示,BV/N 侵犯、临床分期及生存素表达均与预后有关(P<0.05),胃癌组织分化、P53表达与预后无关(P>0.05)。但经多因素 Cox 分析显示,只有临床分期、生存素表达具有独立的预后意义。结论生存素表达与胃癌病理形态特征、临床分期及预后密切相关,似可作为预测胃癌预后不良的指标。
Objective To investigate the role of survivin and P53 in apoptosis of gastric adenocarcinoma, as well as its relationship with the clinicopathologic features and the prognosis. Methods The gastric tissue microarrays were composed of those from 100 cases of gastric cancer and 30 controls. At these tissue microarrays, expressions of survivin and P53 were investigated immunohistochemically, and tumor cell apoptosis index was examined by TUNEL method. Of the 100 cases, 47 cases were followed-up from 14 months to 13 years, in which the survival was analyzed. Results Two paraffin-embedded gastric carcinoma tissue microarrays were successfully constructed, including 114 and 116 tissue spots, respectively. Immunohistochemical analysis showed that survivin was expressed in 78 cases （78%） . No expression of survivin was detected in control tissue （P 〈 0. 01 ）, P53 expression was detected in 52 cases （52%）, No immunoreactivity was observed in the normal tissue （P 〈0.01 ）. The expression of survivin was statistically associated with histological grades, lymph node involvement, invading of vessel and nerve or TNM stages （ P 〈 0. 05 ）. The apoptosis index was lower in survivin positive group （3.2 ± 1.0 ） than in survivin negative group （4.0 ± 1. 1, P 〈 0.01 ）. But no such correlations were observed when P53 expression was analysed （ P 〉 0.05 ）, In the 47 cases with followed-up data, univariant analysis revealed that the survival was correlated with invading of vessel and nerve, TNM stages, and expression of survivin. The histological grades and expression of P53 were not related to prognosis. However, Cox stepwise proportional hazards analysis showed that only TNM staging and survivin status retained significant independently in prospecting prognosis, Conclusions The expression of survivin was associated with the pathologic features, TNM stages and prognosis in gastric carcinoma, indicating that overexpression of survivin may be a poor prognosis factor for gastric carcinoma.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2005年第11期663-667,共5页
Chinese Journal of Digestion
关键词
胃癌
组织芯片
细胞凋亡
生存素
P53蛋白
Gastric carcinoma
Tissue microarrays
Apoptosis
Survivin
P53 protein
