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目的 研究胃癌组织中自发性细胞凋亡的发生情况及其与胃癌临床病理参数和胃癌患者预后的关系。方法 采用脱氧核糖核酸末端转移酶介导的dUTP缺口末端标记 (TUNEL)技术对 5 3例有随访结果的胃癌组织中的凋亡细胞进行原位观察和比较。结果 胃癌组织自发性细胞凋亡指数平均为 5 .76 %。细胞凋亡指数与胃癌患者年龄、性别、肿瘤大小、浸润深度无明显关系 ,与胃癌细胞分化程度、淋巴结转移及临床分期有关 ,高、中分化腺癌凋亡指数显著高于低分化腺癌 (t =3 .0 5 4,P <0 .0 1) ,无淋巴结转移和临床Ⅰ、Ⅱ期胃癌凋亡指数显著高于有淋巴结转移和临床Ⅲ、Ⅳ期胃癌 (t=2 .16 0 ,t =2 .32 2 ,P <0 .0 5 )。高凋亡指数组的胃癌患者生存率优于低凋亡指数组 (Logrank时序检验 χ2 =4.5 70 ,P <0 .0 5 )。结论 胃癌组织自发性细胞凋亡与胃癌的某些生物学特性有密切的关系 ,细胞凋亡异常在胃癌发生发展过程中可能起重要作用。细胞凋亡指数可作为一种预测指标用于胃癌的动态观察及预后判断
Objective To study the occurrence of spontaneous apoptosis in gastric carcinoma and its relationship with clinicopathological parameters and prognosis of gastric cancer. Methods Apoptotic cells in 53 cases of gastric cancer with follow-up results were observed and compared in situ using DNA-terminal transferase-mediated dUTP nick end labeling (TUNEL). Results The average rate of spontaneous apoptosis in gastric cancer was 5.76%. Apoptosis index had no relationship with age, sex, tumor size and depth of invasion in patients with gastric cancer, which was related to the degree of differentiation of gastric cancer, lymph node metastasis and clinical stage. The apoptosis index of high and moderately differentiated adenocarcinoma was significantly higher than that of poorly differentiated adenocarcinoma t = 3. 054, P <0.01). There was no lymph node metastasis and clinical stage Ⅰ, Ⅱ gastric cancer apoptosis index was significantly higher than those with lymph node metastasis and clinical stage Ⅲ, Ⅳ gastric cancer (t = 2.160, t = 2 .32 2, P <0. 05). The survival rate of gastric cancer patients with high apoptosis index group was better than that of low apoptosis index group (χ2 = 4.570, P <0.05) by Logrank test. Conclusion The spontaneous apoptosis in gastric cancer is closely related to some biological characteristics of gastric cancer. Abnormal apoptosis may play an important role in the development and progression of gastric cancer. Apoptosis index can be used as a predictor of gastric cancer dynamic observation and prognosis