中国人胃癌染色体17q21区域基因遗传不稳定性研究

GENETIC INSTABILITY ON CHROMOSOME 17q21 IN GASTRIC CANCER OF CHINESE PATIENTS

研究17号染色体上D17S396位点、D17S579及D17S855位点微卫星不稳定性和杂合性缺失,探讨其对胃癌nm23H_1和BRCAl蛋白表达的影响,为胃癌临床治疗及分析预后提供实验依据。石蜡包埋组织中抽提DNA,应用PCR-单链构象多态性(singlestrandconformationpolymorphism,SSCP),常规银染、Envision免疫组织化学及Leica-Qwin计算机图像分析等方法。结果发现,40例胃癌D17S396位点MSI、LOH检出率和nm23H_1蛋白阳性率分别为20.00%、17.50%和55.00%。40例胃癌D17S579位点MSI、LOH检出率和BRCAl蛋白阳性率分别为22.50%、15.00%和37.50%。37例胃癌D17S855位点MSI、LOH检出率和BRCAl蛋白阳性率分别为18.92%、18.92%和37.84%。在肿瘤TNM分期中,上述3个位点MSI检出率在Ⅰ+Ⅱ期分别高于Ⅲ+Ⅳ期,结果具有统计学意义;而LOH检出率在Ⅲ+Ⅳ期分别高于Ⅰ+Ⅱ期。随着胃癌TNM分期的升高,MSI检出率呈现降低趋势,而LOH检出率有增加趋势。对于D17S396位点,淋巴结转移组的MSI检出率为5.00%,低于无淋巴结转移的35.00%(P<0.05);在淋巴结转移组,LOH检出率为30.00%,高于无淋巴结转移组(5.00%)(P<0.05)。在D17S579位点,MSI检出率随着胃癌分化程度的降低而呈下降趋势,高、中、低分化组阳性率分别为50.00%、20.00%、0%。TNMⅠ+Ⅱ期的nm23H_1蛋白、BRCAl蛋白阳性率明显高于TNMⅢ+Ⅳ期,并随着管状腺癌分化程度升高,它们的阳性率呈增高趋势,均具有统计学意义(P<0.05)。在淋巴结转移组,nm23H_1蛋白阳性率为30.00%,低于无淋巴结转移组的80.00%(P<0.01)。nm23H_1蛋白阳性率在MSI阳性组高于MSI阴性组(P<0.05);而在LOH阳性组nm23H_1蛋白阳性率低于LOH阴性组。BRCAl蛋白阳性率在MSI阳性组高于MSI阴性组(P<0.05)。实验结果提示,MSI和LOH通过不同的途径调控散发性胃癌的发生、转移,MSI可作为胃癌的早期分子指标之一。而nm23H_1蛋白可抑制胃癌转移及恶化,BRCAl蛋白能阻止胃癌向低分化发展,并改善患者预后。

To investigate microsatellite instability (MSI) and loss of heterozygosity (LOH) of locus D17S396, D17S579 and D17S855, and their effect on the expression of nm23H1 and BR- CA1 of gastric cancer, which would provide experimental basis for clinical treatment and prognosis analysis of gastric cancer. DNA was extracted from paraffin-embedded materials. Polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) was used to analyze MSI and LOH. Expression of nm23H_1 and BRCA1 was detected by Envision immune-histochemistry and Leica- Qwin computer imaging techniques. In the forty cases of gastric cancer, the frequency of MSI, LOH and nm23H_1 protein were 20.00%, 17.50% and 55.00% respectively at locus D17S396, while at locus D17S579, the frequency of MSI, LOH and BRCA1 protein were 22.50%, 15.00% and 37.50% respectively; at locus D17S855, the frequency of MSI, LOH and BRCA1 of thirty- seven cases were 18.92%, 18.92%, 37.84% respectively. In tumor node metastasis (TNM) staging, at locus D17S396, D17S579 and D17S855, MSI in stages Ⅰ+Ⅱ appeared more frequently than that in stages Ⅲ+Ⅳ, while LOH appeared the contrary tendency. In the group of metastasis of gastric cancer, MSI had a less frequency (5.00%) than that with no metastasis (35.00%, P<0.05) at locus D17S396, but LOH appeared more frequently (30.00%) than that with no metastasis (5.00%, P<0.05). At locus D17S579, MSI had an increasing tendency with the degree of tumor differentiation (50.00% in high differentiation cases, 20.00% in middle differentiation cases, and 0% in low differentiation cases, P<0.05). The frequency of nm23H1 and BRCA1 protein in stages TNM Ⅰ+Ⅱ was higher than that in stages TNM Ⅲ+Ⅳ; and that in higher differentiation cases was higher than in poor differentiation cases. The frequency of nm23H1 protein in the group of metastasis (30.00%) was less than that with no metastasis significantly (80.00%, P<0.01). The fre- quency of nm23H1 protein in the group positive to MSI (87.50%) was higher than that in the group negative to MSI (46.88%, P<0.05). However, nm23H1 protein in group positive to LOH (14.29%) was lower than that in the group negative to LOH (63.64%, P<0.05). The frequency of BRCA1 protein in the group positive to MSI (66.67%) was more than that in the group negative to MSI (29.03%, P<0.05). The results of experiments indicate that MSI and LOH may separately control the development of sporadic colon cancer with different pathways. MSI may be an early period molecule marker for sporadic colon cancer, enhanced expression of nm23H1 protein can ef- fectively inhibit colon cancer metastasis and improve prognosis of sporadic colon cancer patients. By comparison, LOH mostly arises in the late period of sporadic colon cancer and endows a high aggressive and poor prognostic phenotype. nm23H_1 protein could effectively restrain gastric cancer metastasis and development; and BRCA1 protein could restain tumor from becoming lower differen- tiation.