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目的探讨胃癌组织中p16,c-myc和cox-2表达情况、相互影响及其与预后的关系。方法应用免疫组化SABC法检测104例手术切除胃癌组织中p16,c-myc和cox-2的表达。结果胃癌中p16,c-myc和cox-2表达阳性率分别为39.4%(41/104)、57.7%(60/104)、63.5%(66/104)。p16表达与浸润深度,淋巴结有无转移,TNM分期,组织学类型有关(P<0.05);c-myc表达与浸润深度,淋巴结有无转移,TNM分期有关(P<0.05),而与不同组织学类型无相关性(p>0.05);cox-2表达与淋巴结有无转移,TNM分期,组织学类型有关(P<0.05),而与不同的浸润深度无关(P>0.05)。等级相关分析结果显示,p16与c-myc和cox-2表达呈负相关(P<0.05),c-myc与cox-2表达呈正相关(P<0.05)。生存曲线研究显示P16,c-myc和cox-2表达与患者术后生存时间显著相关(P<0.05)。结论p16在胃癌组织中低表达及c-myc和cox-2高表达能客观反映胃癌组织分化程度和侵袭转移能力,且与预后密切相关。因此,检测三种指标可有助于判断胃癌预后,指导治疗。
Objective To investigate the expression of p16, c-myc and cox-2 in gastric cancer and their relationship with prognosis. Methods The immunohistochemical SABC method was used to detect the expression of p16, c-myc and cox-2 in 104 surgically resected gastric cancer tissues. Results The positive rates of p16, c-myc and cox-2 in gastric cancer were 39.4% (41/104), 57.7% (60/104) and 63.5% (66/104), respectively. The expression of p16 was related to the depth of invasion, lymph node metastasis, TNM stage and histological type (P <0.05). The expression of c-myc was related to the depth of invasion, lymph node metastasis and TNM staging (P <0.05) No correlation was found between the two groups (p> 0.05). The expression of cox-2 was correlated with lymph node metastasis, TNM stage and histological type (P <0.05), but not with depth of invasion (P> 0.05). The results of rank correlation analysis showed that p16 was negatively correlated with c-myc and cox-2 (P <0.05), and c-myc was positively correlated with cox-2 (P <0.05). Survival curves showed that the expression of P16, c-myc and cox-2 were significantly correlated with postoperative survival time (P <0.05). Conclusion The low expression of p16 in gastric cancer tissues and the high expression of c-myc and cox-2 can objectively reflect the degree of differentiation and invasion and metastasis of gastric cancer, which is closely related to the prognosis. Therefore, the detection of three indicators can help determine the prognosis of gastric cancer, guiding treatment.