P选择素在胃癌、肾癌中表达及其意义

Expression of P-selectin in Gastric and Renal Cell Carcinomas

目的:P选择素可介导血小板、内皮细胞与肿瘤细胞相互粘附和作用,本研究探讨了P选择素与肿瘤转移的关系。方法:用P选择素单抗和免疫组化技术,检测60例胃癌和20例肾癌组织P选择素表达,并对55例胃癌作5年以上随访。结果:60例胃癌组织中P选择素阳性表达为32例,阳性率为53.3％;20例肾癌的阳性表达11例,阳性率为55.0％。P选择素不仅在肿瘤血管内皮上表达,也可在肿瘤细胞膜上表达。胃癌淋巴结转移者P选择素阳性表达率为70.3％,显著高于无淋巴结转移的26.1％,P<0.01。P选择素在Ⅲ、Ⅳ期肿瘤的阳性表达率明显高于Ⅰ、Ⅱ期肿瘤(胃癌,分别为80.0％和26.7％,P<0.01;肾癌,分别为87.5％和33.3％,P<0.05)。此外55例胃癌中P选择素阳性表达者的平均生存期25.5±21.8月和5年生存率为10.7％,显著低于阴性表达者(P<0.01)。结论:P选择素与胃癌、肾癌的浸润转移有关,并可能是一种观察肿瘤预后的新指标。

Expression of P-selectin in tumor tissues was determined im-munohistoehemically in 60 cases of gastric cancer and 20 cases of renal cell carcinoma. The results showed that in 32 of the gastric cancer cases(53.3%), positive staining was detected on the endothelium of intratumoral vessels, as well as on the cell membrane of cancer tissue. Eleven of the renal cell cancinoma cases were demonstrated positive staining(55%). The rate of P-selectin expression was higher in patients with positive lymph-nodes than in those with negative lymph-nodes(70.3% vs 26.1%, P<0.01); it was also higher in stageⅢ&Ⅳ cases than in stage I & Ⅱ cases (80% vs 26.7% in gastric cancer, P<0.01; 87.5% vs 33.3% in renal cell carcinoma, P<0.05). The survival time and 5-yr survival rate was statistically lower in P-selectin positive gastric cancer cases than in those with negative P-selectin. In conclusion, P-selectin expression is associated with the depth of invasion and the rate of metastasis, and consequently with the prognosis of the cancers studied.