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目的:P选择素可介导血小板、内皮细胞与肿瘤细胞相互粘附和作用,本研究探讨了P选择素与肿瘤转移的关系。方法:用P选择素单抗和免疫组化技术,检测60例胃癌和20例肾癌组织P选择素表达,并对55例胃癌作5年以上随访。结果:60例胃癌组织中P选择素阳性表达为32例,阳性率为53.3％;20例肾癌的阳性表达11例,阳性率为55.0％。P选择素不仅在肿瘤血管内皮上表达,也可在肿瘤细胞膜上表达。胃癌淋巴结转移者P选择素阳性表达率为70.3％,显著高于无淋巴结转移的26.1％,P<0.01。P选择素在Ⅲ、Ⅳ期肿瘤的阳性表达率明显高于Ⅰ、Ⅱ期肿瘤(胃癌,分别为80.0％和26.7％,P<0.01;肾癌,分别为87.5％和33.3％,P<0.05)。此外55例胃癌中P选择素阳性表达者的平均生存期25.5±21.8月和5年生存率为10.7％,显著低于阴性表达者(P<0.01)。结论:P选择素与胃癌、肾癌的浸润转移有关,并可能是一种观察肿瘤预后的新指标。
Objective: P-selectin can mediate the adhesion and action of platelets, endothelial cells and tumor cells. This study investigated the relationship between P-selectin and tumor metastasis. Methods: The expression of P-selectin in 60 cases of gastric cancer and 20 cases of renal cell carcinoma was detected by P-selectin monoclonal antibody and immunohistochemistry. 55 cases of gastric cancer were followed up for more than 5 years. Results: The positive expression rate of P-selectin in 60 cases was 53.3%. The positive rate of P-selectin in 20 cases of renal cell carcinoma was 11 cases (55.0%). P-selectin is not only expressed on the tumor vascular endothelium, but also expressed on the tumor cell membrane. The positive rate of P-selectin in gastric cancer with lymph node metastasis was 70.3%, which was significantly higher than that in non-lymph node metastasis (26.1%, P <0.01). The positive rates of P-selectin in stage III and IV tumors were significantly higher than those in stage I and II tumors (80.0% and 26.7%, respectively, P <0.01; 87.5% and 33.3%, respectively, ). In addition, the average survival time of P-selectin positive patients in 55 cases of gastric cancer was 25.5 ± 21.8 months and 5-year survival rate was 10.7%, which was significantly lower than that of negative expression (P <0.01). Conclusion: P-selectin is associated with invasion and metastasis of gastric cancer and renal cell carcinoma and may be a new indicator to observe the prognosis of the tumor.