生存素和PTEN表达在全淋巴结检查胃癌中的意义
Significance of Survivin and PTEN expression in full lymph node-examined gastric cancer.
作者信息
Deng Hao, Wu Ren-Liang, Zhou Hong-Yan, Huang Xuan, Chen Ying, Liu Li-Jiang
机构信息
Department of Pathology and Pathophsyiology, Medical and Life Science College, Jianghan University, Wuhan 430030, Hubei Province, China.
出版信息
World J Gastroenterol. 2006 Feb 21;12(7):1013-7. doi: 10.3748/wjg.v12.i7.1013.
AIM
To study the relationship between Survivin and PTEN expression and lymph node metastasis, depth of invasion and prognosis of gastric cancer patients in China.
METHODS
Specimens of gastric cancer tissue were collected from the Affiliated Hospital of Jianghan University. All the 140 patients had complete examination data. All lymph nodes were found by the fat-clearing method. The interrupted serial 4-micron sections, routine hematoxylin and eosin staining and immunohistochemical methods were used to detect the lymph node metastases. Gastric cancer tissue microarray was performed to test the expression of Survivin and PTEN (17A) in gastric cancer by immunohistochemical method. All data were processed using chi2 test, Fisher's exact test, Kaplan-Meyer Log-rank method and Cox multivariate analysis (SPSS 12.0 software).
RESULTS
One hundred and eighteen specimens were used in our tissue microarray (utilization rate was 82.4%). A total of 7580 lymph nodes were found. Metastases were found in 90 specimens and 1618 lymph nodes were detected. The positive rate of Survivin and PTEN expression was 52.5% (62/118) and 76.2% (90/118), respectively. A highly positive correlation was found between Survivin and PTEN expression (chi2 = 4.17, P = 0.04). Survivin expression was positively correlated with UICC N stage (chi 2 = 8.69, P = 0.03) and histological classification (chi2 = 4.41, P = 0.04) by chi2 tests. PTEN expression was positively correlated with depth of invasion (P = 0.02) and histological classification (chi2 = 5.47, P = 0.02). But Survivin and PTEN expressions were not related with prognosis of gastric cancer patients. A significant correlation between lymph node metastasis and prognosis was demonstrated by Cox multivariate analysis (chi2 = 4.85, P = 0.028).
CONCLUSION
Survivin is positively correlated with PTEN expression in gastric cancer and is a molecular marker of lymph node metastasis while PTEN expression is a molecular marker of advanced gastric cancer. UICC N stage is the most important prognostic factor of gastric cancer in China.
目的
研究Survivin与PTEN表达与中国胃癌患者淋巴结转移、浸润深度及预后的关系。
方法
收集江汉大学附属医院的胃癌组织标本。140例患者均有完整的检查资料。采用脂肪清除法查找所有淋巴结。用间断连续4微米切片、常规苏木精-伊红染色及免疫组化方法检测淋巴结转移情况。采用免疫组化方法对胃癌组织芯片进行检测，以检测Survivin和PTEN（17A）在胃癌中的表达。所有数据采用卡方检验、Fisher确切概率法、Kaplan-Meier对数秩检验和Cox多因素分析（SPSS 12.0软件）进行处理。
结果
118份标本用于组织芯片制作（利用率为82.4%）。共发现7580个淋巴结。90份标本发现转移，检测到1618个转移淋巴结。Survivin和PTEN表达阳性率分别为52.5%（62/118）和76.2%（90/118）。Survivin与PTEN表达呈高度正相关（卡方 = 4.17，P = 0.04）。经卡方检验，Survivin表达与UICC N分期（卡方 = 8.69，P = 0.03）及组织学分类（卡方 = 4.41，P = 0.04）呈正相关。PTEN表达与浸润深度（P = 0.02）及组织学分类（卡方 = 5.47，P = 0.02）呈正相关。但Survivin和PTEN表达与胃癌患者预后无关。Cox多因素分析显示淋巴结转移与预后有显著相关性（卡方 = 4.85，P = 0.028）。
结论
胃癌中Survivin与PTEN表达呈正相关，Survivin是淋巴结转移的分子标志物，而PTEN表达是进展期胃癌的分子标志物。UICC N分期是中国胃癌最重要的预后因素。
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