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目的 :探讨癌基因HER2、mdm 2和C myc扩增与胃癌恶性程度、转移及预后的关系。 方法 :用差异竞争性多聚酶链反应检测胃癌原发灶、癌旁、转移淋巴结及远处脏器转移癌中HER2、mdm 2和C myc的基因变异。结果 :HER2扩增频率在近端胃癌组中明显高于远端胃癌组 (分别是 11/ 13和 5 / 19,P <0 .0 0 5 ) ,侵及浆膜组明显高于未侵及浆膜组 (12 / 18和 4/ 14,P <0 .0 5 )。mdm 2的扩增频率在转移淋巴结中高于胃原发癌 (12 / 2 1和 12 / 32 ,P>0 .0 5 ) ,在 3例淋巴结微转移灶中发现mdm 2扩增。C myc在胃癌原发灶及转移淋巴结中的扩增频率分别是6 / 32和 5 / 2 1,2例远处脏器转移癌中有扩增。结论 :HER2、mdm 2和C myc基因扩增与胃癌的快速生长有关 ,三者联合检测可能为判断胃癌恶性程度、转移及预后提供有价值的信息。
Objective: To investigate the relationship between the amplification of oncogenes HER2, mdm 2 and C myc and the degree of malignancy, metastasis and prognosis of gastric cancer. METHODS: Gene mutations of HER2, mdm2, and C myc in primary gastric cancer, paracancerous, metastatic lymph nodes, and distant metastases were detected by differentially-competitive polymerase chain reaction. Results: The frequency of HER2 amplification in the proximal gastric cancer group was significantly higher than that in the distal gastric cancer group (11/13 and 5/19, respectively, P < 0.05). The invading serosa group was significantly higher than the non-invasive. Serosa group (12/18 and 4/14, P<0.05). The amplification frequency of mdm 2 was higher in metastatic lymph nodes than that in primary gastric cancer (12/2 1 and 12/32, P>0.05). Mdm 2 amplification was found in 3 lymph node micrometastases. The amplification frequency of C myc in primary gastric cancer and metastatic lymph nodes was 6/32 and 5/21, respectively, in 2 distant metastases. Conclusion : The amplification of HER2, mdm 2 and C myc genes is related to the rapid growth of gastric cancer. The combined detection of these three genes may provide valuable information for judging the malignancy, metastasis and prognosis of gastric cancer.