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背景及目的:分子生物学研究表明COX-2、p53、PCNA和nm23基因蛋白异常表达与胃癌发生发展密切相关,有关它们异常表达与胃癌生物学行为的关系尚不清楚。本文旨在了解它们与胃癌临床病理生物学行为的关系。方法:用免疫组化(SP)方法检测胃癌手术切除71例标本中上述基因表达。结果:(1)胃癌COX-2过表达率为70.4%(50/71例),且过表达与肿瘤大小、大体类型、组织学类型、淋巴结转移(LN)及临床病理分期密切相关(P<0.05或0.01)。(2)71例胃癌标本的p53和PCNA过表达率分别为74.6%和78.9%,其中LN(+)胃癌p53和PCNA过表达(86.7%和88.8%)分别高于LN(-)病例(53.8%和61.5%)(P<0.05),且Ⅰ+Ⅱ期胃癌的p53和PCNA过表达率分别(52.2%和60.9%)显著低于Ⅲ+Ⅳ期病例(85.4%和87.5%)(P<0.05)。(3)LN(-)病例的nm23低表达率(88.5%)显著低于LN(+)病例的62.2%(P<0.05);且Ⅰ+Ⅱ期病例的nm23低表达91.3%明显高于Ⅲ+Ⅳ期病例62.5%(P<0.05)。(4)COX-2与p53、PCNA和nm23基因2个以上表达病例与表达异常或单因素表达异常者相比,在组织学类型、癌浸润深度、淋巴结转移及临床分期差异显著(P<0.05或P<0.01)。结论:胃癌COX-2与p53、PCNA和nm23异常表达与胃癌淋巴结转移和疾病进展等生物学行为密切相关。
BACKGROUND AND OBJECTIVE: Molecular biology studies have shown that the abnormal expression of COX-2, p53, PCNA and nm23 gene proteins is closely related to the occurrence and development of gastric cancer. The relationship between their abnormal expression and the biological behavior of gastric cancer is unclear. This article aims to understand their relationship with the clinical pathobiological behavior of gastric cancer. Methods: Immunohistochemistry (SP) was used to detect the expression of the above genes in 71 cases of gastric cancer. Results: (1) The overexpression rate of COX-2 in gastric cancer was 70.4% (50/71 cases), and overexpression was closely related to tumor size, gross type, histological type, lymph node metastasis (LN) and clinical pathological stage (P< 0.05 or 0.01). (2) The overexpression rates of p53 and PCNA were 71.6% and 78.9% in 71 gastric cancer specimens, respectively. Among them, the overexpression of p53 and PCNA in LN(+) gastric cancer (86.7% and 88.8%) was higher than that in LN(-) cases (53.8). (% and 61.5%) (P<0.05), and the overexpression rates of p53 and PCNA in stage I+II gastric cancer (52.2% and 60.9%) were significantly lower than those in stage III+IV (85.4% and 87.5%) (P< 0.05). (3) The low expression rate of nm23 in cases of LN(-) (88.5%) was significantly lower than that of LN(+) cases (62.2%) (P<0.05); and the low expression of nm23 in stage I+II cases was significantly higher than that of III. 62.5% of patients in +IV stage (P<0.05). (4) There were significant differences in histological types, cancer invasion depth, lymph node metastasis, and clinical stage between two cases of COX-2 and p53, PCNA, and nm23 gene expression compared with those with abnormal expression or univariate expression (P<0.05). Or P<0.01). Conclusion: The abnormal expression of COX-2, p53, PCNA and nm23 in gastric carcinoma is closely related to the biological behaviors of gastric cancer such as lymph node metastasis and disease progression.