论文部分内容阅读
目的：寻找胃癌临床病理特征和预后的可靠分子指标，建立一种能被临床普遍应用的简易方法。方法：应用免疫组化法检测了具有随访资料的171例胃癌标本中p53、nm23、c-erbB－2、EGFR和E-钙粘蛋白（E－cadherin，简写为E－cad）的表达。结果：（1）Cox比例风险模型多因素分析表明，p53、c－erbB－2、EGFR和E－cad是影响胃癌预后的因子；p53、c－erbB－2及EGFR表达的胃癌病人预后差，而E－cad表达则病人预后好。（2）nm23和E－cad的表达与浸润深度显著相关，癌组织浸润越深，其表达越少（P＜0．05）；有淋巴结转移和远处转移者的p53和EGFR表达率高于无淋巴结转移和无远处转移者（P＜0．05），而有淋巴结转移和远处转移者的nm23和E－cad的表达率低于无淋巴结转移和无远处转移者（P＜0．05）。结论：（1）测定EGFR、E－cad、c－erbB－2和p53基因的表达，对临床判断病人预后及指导治疗有较大的帮助；(2)c-erbB－2和EGFR同步表达对胃癌的进展可能有协同作用。
Objective: To find a reliable molecular indicator of clinical pathological characteristics and prognosis of gastric cancer, and to establish a simple method that can be widely used in clinical practice. Methods: Immunohistochemistry was used to detect the expression of p53, nm23, c-erbB-2, EGFR and E-cadherin (E-cad) in 171 gastric cancer specimens with follow-up data. Results: (1) Multivariate analysis of Cox proportional hazards model showed that p53, c-erbB-2, EGFR and E-cad were the factors affecting the prognosis of gastric cancer; the prognosis of gastric cancer patients with p53, c-erbB-2 and EGFR expression was poor. E-cad expression is a good prognosis. (2) The expression of nm23 and E-cad was significantly correlated with the depth of infiltration. The deeper the infiltration of cancer tissue, the lower the expression of nm23 and E-cad (P<0.05). The expression of nm23 and E-cad was higher in those with lymph node metastasis and distant metastasis. No lymph node metastasis and distant metastasis (P<0.05), but the expression of nm23 and E-cad in lymph node metastasis and distant metastasis were lower than those without lymph node metastasis and no distant metastasis (P<0). .05). Conclusions: (1) The expressions of EGFR, E-cad, c-erbB-2 and p53 genes were determined to be of great help in judging the prognosis and guiding treatment of patients; (2) Simultaneous expression of c-erbB-2 and EGFR The progress of gastric cancer may have a synergistic effect.