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目的探讨胃癌组织中趋化因子受体4(CXCR4)的表达与临床病理、术后肿瘤转移复发及预后的关系。方法 141例胃癌组织及癌旁组织取自安徽医科大学附属省立医院普通外科2007年11月至2008年11月间外科手术患者标本,用免疫组化检测胃癌、癌旁组织中CXCR4的表达,分析其与胃癌临床病理特征的关系,进行3年随访,分析胃癌组织中CXCR4表达与转移复发以及预后的相关性。结果 CXCR4在胃癌组织中阳性表达为60.3%(85/141),在癌旁组织的表达为26.2%(37/141),两组差异有统计学意义(P<0.05)。胃癌组织中CXCR4表达与胃癌TNM分期、淋巴结转移、浸润深度、胰腺包膜累及与否有关(P<0.05)。多参数Logistic回归模型分析显示,淋巴结转移、胃癌术后复发与胃癌组织中CXCR4表达有关(P<0.05)。胃癌CXCR4阳性表达组3年生存率低于阴性表达组(43.1%vs 56.6%,P<0.05)。结论 CXCR4在胃癌组织中存在过度表达,与胃癌淋巴结转移、术后转移复发呈正相关性,胃癌组织CXCR4阳性表达组生存率低于阴性表达组,CXCR4有望作为预测胃癌淋巴转移、术后复发以及预后的指标。
Objective To investigate the relationship between the expression of chemokine receptor 4 (CXCR4) and the clinicopathology, tumor metastasis, recurrence and prognosis in gastric cancer. Methods A total of 141 gastric cancer tissues and adjacent tissues were obtained from surgical patients in General Surgery Department of Provincial Hospital Affiliated to Anhui Medical University from November 2007 to November 2008. The expression of CXCR4 in gastric cancer and paracancerous tissues was detected by immunohistochemistry, The relationship between the expression of CXCR4 and the clinicopathological characteristics of gastric cancer was analyzed. After 3 years of follow-up, the correlation between the expression of CXCR4 and metastasis, recurrence and prognosis of gastric cancer was analyzed. Results The positive expression rate of CXCR4 in gastric cancer tissues was 60.3% (85/141) and that in adjacent tissues was 26.2% (37/141). There was significant difference between the two groups (P <0.05). The expression of CXCR4 in gastric cancer was related to TNM staging, lymph node metastasis, depth of invasion and involvement of pancreatic capsule (P <0.05). Multiple logistic regression analysis showed that lymph node metastasis and gastric cancer recurrence were related to the expression of CXCR4 (P <0.05). The 3-year survival rate of gastric cancer CXCR4 positive expression group was lower than that of negative expression group (43.1% vs 56.6%, P <0.05). Conclusion CXCR4 is overexpressed in gastric cancer, which is positively correlated with lymph node metastasis and postoperative metastasis and recurrence. The survival rate of CXCR4 positive group is lower than that of negative group. CXCR4 is expected to predict the prognosis of lymph node metastasis, postoperative recurrence and prognosis index of.