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目的研究三叶因子3(TFF3)和CD147在不同胃黏膜病变中的表达,探讨其在胃癌的发生发展中的作用。方法采用组织芯片技术制作30例正常胃组织、272例病变胃组织的组织芯片,同时采用SP免疫组化方法检测TFF3和CD147表达(以阳性表达率和平均积分判断结果)。结果TFF3和CD147阳性表达率在正常胃黏膜、浅表性胃炎、萎缩性胃炎、不典型增生和胃癌中分别为3.6%、14.3%;13.3%、43.3%;48.3%、51.2%;51.9%、59.3%和41.7%、78.9%。萎缩性胃炎、不典型增生和胃癌各组TFF3阳性表达率和平均积分均高于浅表性胃炎和正常胃黏膜(P均<0.01);浅表性胃炎CD147表达与正常胃黏膜间差异有统计学意义(P<0.05),胃癌组明显高于浅表性胃炎、萎缩性胃炎(P<0.01)和不典型增生(P<0.05)。TFF3表达与胃癌组织学类型、淋巴结转移和TNM分期有关(P<0.05),CD147表达与胃癌分化程度、浸润深度、淋巴结转移和TNM分期有关(P<0.05);TFF3(+)/CD147(+)者在深度浸润(T3-4)、临床分期TNMⅢ-Ⅳ与淋巴结转移的比率最高,且明显高于TFF3(-)/CD147(-)者(P<0.05)。结论TFF3、CD147可能参与胃黏膜保护及修复,在癌变过程中被激活而参与胃癌的发生发展,可作为较为理想的肿瘤标志物用于胃癌的早期诊断和转移的预警。
Objective To investigate the expression of trefoil factor 3 (TFF3) and CD147 in gastric mucosal lesions and to explore its role in the development of gastric cancer. Methods Tissue microarray was used to prepare tissue microarray of 30 normal gastric tissue and 272 gastric mucosal lesions. SP immunohistochemistry was used to detect the expression of TFF3 and CD147 (positive rate and average score). Results The positive expression rates of TFF3 and CD147 in normal gastric mucosa, superficial gastritis, atrophic gastritis, dysplasia and gastric cancer were 3.6%, 14.3%, 13.3%, 43.3%, 48.3%, 51.2%, 51.9% 59.3% and 41.7%, 78.9%. The positive expression rate and average integral of TFF3 in atrophic gastritis, atypical hyperplasia and gastric cancer groups were higher than those in superficial gastritis and normal gastric mucosa (all P <0.01). The difference between CD147 expression in superficial gastritis and normal gastric mucosa was statistically significant (P <0.05), gastric cancer group was significantly higher than superficial gastritis, atrophic gastritis (P <0.01) and dysplasia (P <0.05). The expression of TFF3 was correlated with histological type, lymph node metastasis and TNM stage (P <0.05). The expression of CD147 was correlated with the degree of differentiation, depth of invasion, lymph node metastasis and TNM staging (P <0.05); TFF3 + CD147 + ) Had the highest rate of TNMⅢ-Ⅳ and lymph node metastasis in patients with advanced infiltration (T3-4), which was significantly higher than that of TFF3 (-) / CD147 (-) (P <0.05). Conclusion TFF3 and CD147 may be involved in the protection and repair of gastric mucosa. They may be involved in the carcinogenesis and progression of gastric cancer during carcinogenesis. They may be used as an ideal tumor marker for early diagnosis and metastasis of gastric cancer.