胃癌p53、c-erbB-2、p21、nm23基因表达的分布特点及其临床意义

目的为探讨手术切除胃癌组织p53、c-erbB-2、p21、nm23联合基因产物表达检测对胃癌诊断治疗及预后判断的价值。方法应用免疫组化技术检测了手术切除胃癌组织p53c、-erbB-2、p21、nm23基因产物表达。结果p53蛋白表达阳性率为36.4%~46.7%,c-erbB-2为33.3%~56.8%,p21为35.1%~56.7%,nm23为30.0%~70.5%。在非胃癌组织中(胃,十二指肠溃疡,胃息肉,重度不典型增生)未见c-erbB-2、p21、nm23基因表达。p53c、-erbB-2、p21的表达与胃癌的分化程度,肿瘤浸润程度,肿瘤转移程度及临床分期呈正相关。nm23的表达与胃癌的分化程度,肿瘤浸润程度,肿瘤转移程度及临床分期呈负相关。p53c、-erbB-2、p21n、m23四种肿瘤蛋白在胃镜活检标本和手术切除标本中表达无显著性差异,胃镜活检标本和手术切除标本检测阳性符合率分别为90.2%、91.0%、93.7%和89.3%。结论对胃癌组织p53、c-erbB-2、p21、nm23基因表达检测在胃部良恶性肿瘤鉴别,非手术临床分期的判断及指导临床治疗等方面具有一定价值。多基因表达检测对胃癌预后判断明显优于单基因表达检测。

The clinical significance and distributing characteristic of p53, c-erbB-2, p21, nm23 oncoprotein expression in gastric tissue speciments

Objective To sdudy on comparision of detection of p53, c-erbB-2, p21, nm23 oncoprotein expression between gastric cancerous resected tissue speeiments and biopsy speeiments and evaluate p53, c-erbB-2, p21, nm23 oncoprotein expression in diagnosis and treatment of gastric cancer. Methods The expression of 1363, c-erbB-2, p21, mn23 oncoproteins was detected with method in 74 surgically resected specimens and its endoscopic biopsy speeiments of gastric cancer. Results Tbe positive rates of p53, c-erbB-2, p21,nm23 oncoprotein expression were 36.4% - 46.7%,33.3% - 56.8%,35.1% - 56.7%, and 30.3% - 70.5% respectively. Oncoprotein expression was not observed in non-tuor endoscopic biopsy speciments. The expression of p53, c-erbB-2, p21 were positively correlated with grade of tumor differentiation, the depth of tumor invasion and clinical different stages and the expression of nm23 were negatively corre41ated with grade of tumor differentiation, the depth of tumor invasion and clinical different stages. Positive coincidence rates of p53, c-erbB-2, p21, nm23 were 90.2%, 91.0%, 93.7% and 89.3% respectively between biopsy and resected spedments. Conclusion Determination of p53, c-erbB-2, p21, nm23 oncoprotein was might be useful in diagnosis and treatment of gastric cancer, differentiating benign and malignant tumor clinical stages and better than single gene in predicting prognosis of gastric cancer.