KIF3A在不同病变胃组织及淋巴结转移灶中的表达及其与胃腺癌转移和预后的关系

目的 检测KIF3A在不同病变胃组织及淋巴结转移灶中的表达，探讨其与胃腺癌发生、转移、临床病理特征及预后的关系。方法 应用免疫组织化学技术检测不同胃组织及淋巴结转移灶中KIF3A的表达。采用SPSS23.0软件包对数据进行统计分析。结果 KIF3A在胃腺癌组织中的表达水平明显高于癌旁相对正常组织（P<0.01），而淋巴结转移灶中的表达水平较相应原发灶中更高（P<0.01）；低级别、高级别上皮内瘤变中KIF3A的表达水平均明显高于慢性胃炎组织（P<0.01）；KIF3A的表达与进展期胃腺癌患者的TNM分期、淋巴结转移、脉管侵犯相关（P<0.05）；进展期胃腺癌患者中，KIF3A高表达者总体生存和无病生存时间较低表达者明显缩短（P<0.01），且KIF3A在细胞质及细胞核都有表达者总体生存时间较仅细胞质表达者短（P<0.05）； Cox多因素分析显示，KIF3A是胃腺癌患者总体生存期与无病生存期的独立危险因素（P<0.05）。结论 KIF3A可能与胃黏膜上皮内瘤变的发生有关，其表达增强和核表达可能与进展期胃腺癌患者预后不良有关，是进展期胃腺癌患者的独立预后因素。

Expression of KIF3A in Different Gastric Mucosal Lesions,Metastatic Lymph Nodes and Its Relationship with Metastasis and Prognosis of Gastric Adenocarcinoma

Objective To investigate the expression of KIF3A in different gastric mucosal lesions and corresponding metastatic lymph nodes, and to explore its relationship with the occurrence, clinicopathologic characteristics, metastasis and prognosis of gastric adenocarcinoma. Methods The expression of KIF3A was detected immunohistochemically in different gastric mucosal lesions and corresponding metastatic lymph nodes. SPSS23.0 software package was used for statistical analysis. Results The expression of KIF3A was higher in gastric adenocarcinoma tissues than that in corresponding adjacent tissues(P<0.01), and it was also higher in metastatic lymph nodes than that in corresponding primary lesions(P<0.01). The expression of KIF3A both in low- and high-grade intraepithelial neoplasia were significantly higher than that in chronic gastritis(P<0.01). In addition, KIF3A expression in advanced gastric adenocarcinoma was correlated with TNM grade, lymph node metastasis and vascular invasion(P<0.05). Patients with high expression of KIF3A had shorter overall survival and disease-free survival than those with low expression of KIF3A(P<0.01), and patients with both cytoplasm and nuclear expression of KIF3A had shorter overall survival than those with exclusively cytoplasmic distribution(P<0.05). COX multivariate analysis showed that high expression of KIF3A was an independent risk factor for overall survival and disease-free survival of patients with gastric adenocarcinoma(P<0.05). Conclusion KIF3A may be correlated with intraepithelial neoplasia of gastric mucosa. Both the up-regulation of KIF3A and nuclear expression of KIF3A may be related to poor prognosis of advanced gastric adenocarcinoma patients. KIF3A may be an independent prognostic factor for advanced gastric adenocarcinoma.