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目的：对胃癌中变异Ｐ１６ＩＮＫ４和ｎｍ２３－Ｈ１的表达进行研究，在分子生物学水平上探讨它们在判断胃癌预后方面优于病理指标的可能性。方法：应用过氧化酶标记的链酶亲和素（ＨＩＧＨ－ＳＡＢＣ）染色法对１０１例胃癌进行免疫组化染色。对染色结果进行观察，变异Ｐ１６ＩＮＫ４的染色结果采用已知乳腺癌阳性切片作为对照；ｎｍ２３－Ｈ１的染色结果参照Ｓｏｎｇｕｎ标准。所有数据进行ｌｏｇｉｓｔｉｃ回归分析，生存期与诸因素的关系采用Ｃｏｘ风险模型。结果：在１０１例胃癌病例中Ｐ１６ＩＮＫ４的阳性表达率随着胃癌浸润深度的加深、淋巴结／脏器转移而增高并与术后复发有关（Ｐ＜０．０５）；而ｎｍ２３－Ｈ１的阳性表达率随着胃癌浸润深度加深、淋巴结／脏器转移、术后复发而降低并与病人的生存时间成正相关（Ｐ＜０．０５）。结论：Ｐ１６ＩＮＫ４和ｎｍ２３－Ｈ１表达的检测在判断胃癌恶性程度及淋巴结／脏器转移趋势方面具有一定参考价值。在判断胃癌的术后复发、生存期及预后方面，Ｐ１６ＩＮＫ４是非保护性因素而ｎｍ２３－Ｈ１是保护性因素，它们在胃癌预后判断上可以弥补病理指标的不足。
OBJECTIVE: To investigate the expression of mutations P16INK4 and nm23-H1 in gastric cancer, and to explore the possibility of them being superior to pathological indicators in judging the prognosis of gastric cancer at the molecular biology level. METHODS: Immunohistochemical staining of 101 cases of gastric cancer was performed using a peroxidase-labeled streptavidin (HIGH-SABC) staining method. The staining results were observed. The staining results of the mutant P16INK4 were determined using positive sections of known breast cancer as controls. The staining results of nm23-H1 were referenced to the Songun criteria. All data were subjected to logistic regression analysis. The relationship between survival time and various factors was based on the Cox risk model. RESULTS: The positive expression rate of P16INK4 in 101 cases of gastric cancer was increased with deepening of gastric cancer invasion and metastasis of lymph nodes/organs and correlated with postoperative recurrence (P<0.05). The positive expression rate of nm23-H1 was positive. With the deepening of gastric cancer invasion, lymph node/organ metastasis, postoperative recurrence decreased and positive correlation with the patient’s survival time (P <0.05). Conclusion: The detection of the expression of P16INK4 and nm23-H1 has certain reference value in judging the malignant degree of gastric cancer and the metastatic tendency of lymph nodes/organs. In the judgment of postoperative recurrence, survival and prognosis of gastric cancer, P16INK4 is a non-protective factor and nm23-H1 is a protective factor. They can compensate for the lack of pathological indicators in the prognosis of gastric cancer.