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目的探讨胃腺癌(GAC)患者术前腹腔冲洗液细胞DNA中结肠腺瘤性息肉(APC)基因启动子区域5’-CpG岛异常甲基化及其临床意义。方法用实时荧光甲基化特异性聚合酶链反应(real time-MSP)检测92例GAC患者术前腹腔冲洗液细胞中APC基因异常甲基化状况,分析APC基因异常甲基化与患者临床病理因素及预后之间的关系。结果在92例GAC患者术前腹腔冲洗细胞标本中,有49例(53.26%)APC基因异常甲基化,其中28例(30.43%)完全甲基化,21例(22.83%)半甲基化。APC基因异常甲基化分别与GAC的生长方式、分化程度、浸润程度、淋巴结转移、远处转移及临床分期有统计学意义(P<0.05);生存分析表明,胃癌患者中APC基因异常甲基化组的中位生存时间为21.5个月,非甲基化组为41.5个月,差异有统计学意义(P<0.05),COX回归分析显示APC基因异常甲基化与淋巴结转移、远处转移及TNM分期影响GAC患者的预后。结论术前腹腔冲洗液细胞DNA中APC基因异常甲基化可反映GAC进展状况,并提示患者预后不良。
Objective To investigate the abnormal methylation of 5’-CpG island in the promoter region of colon adenomatous polyps (APC) gene in DNA from preoperative peritoneal washings of patients with gastric adenocarcinoma (GAC) and its clinical significance. Methods The abnormal methylation status of APC gene in 92 patients with GAC before operation was detected by real time-MSP. The abnormal methylation of APC gene and the clinical pathology Relationship between factors and prognosis. Results In 92 preoperative peritoneal lavage samples of GAC patients, 49 cases (53.26%) had abnormal methylation of APC gene, including 28 cases (30.43%) completely methylated and 21 cases (22.83%) hemomethylated . The abnormal methylation of APC gene was associated with the growth pattern, differentiation degree, infiltration degree, lymph node metastasis, distant metastasis and clinical stage of GAC, respectively (P <0.05). Survival analysis showed that the abnormal methylation of APC gene in gastric cancer The median survival time was 21.5 months in non-methylated group and 41.5 months in non-methylated group, the difference was statistically significant (P <0.05). COX regression analysis showed that abnormal methylation of APC gene was associated with lymph node metastasis and distant metastasis And TNM staging affect the prognosis of GAC patients. Conclusions Abnormal methylation of APC gene in preoperative peritoneal washings can reflect the progress of GAC and suggest that patients have poor prognosis.