多个基因在青 老年人胃癌中表达的比较研究

Comparison of Gene Expression in Gastric Cancer of the Young and the Old

目的:从转录水平探讨青、老年人胃癌不同临床特点的分子生物学基础。方法:以41例老年人(≥60岁)和16例青年人(≤35岁)的胃癌患者为研究对象,采用RT-PCR方法检测多个基因mRNA表达,比较青、老年人胃癌间的临床病理特点和遗传学差异。结果:青年人以低分化、印戒或粘液腺癌为主;老年人以高、中分化的管状、乳头状腺癌为主(P<0.05)。青年人胃癌组织中S100A4高表达和nm23H1低表达均较老年人明显(P<0.05)。青年人中,癌穿透浆膜nm23H1表达明显低于未穿透浆膜者;低分化MMP-7表达明显高于高、中分化者;伴淋巴结转移及转移重S100A4表达明显高于无淋巴结转移及转移轻者(P<0.05)。老年人中,低分化nm23H1表达明显低于高、中分化者;伴淋巴结转移Heparanase表达明显高于无淋巴结转移者;淋巴结转移重及小结节孤立型MMP-7表达明显高于淋巴结转移轻及大结节融合型和一般型者(P<0.05)。结论:青、老年人胃癌具有不同的临床病理特点,S100A4、MMP-7、Heparanase和nm23H1基因可能是参与调控青、老年人胃癌不同生物学行为的重要基因,上述基因表达测定可作为胃癌分化、侵袭和转移程度判定的参考指标。

Objective： To explore the molecular biological foundation of the different clinical manifestations of gastric cancer between the young and the old. Methods： A total of 57 cases, 41 cases older than 60 and 16 cases younger than 35, were selected randomly. The mRNA expression of heparanase, MMP-7, S100A4 and nm23H1 genes in the primary gastric lesions was detected by RT-PCR. The difference in clinicopathological features and genetics between the two groups was compared. Resuits： In patients younger than 35, poorly differentiated carcinoma, signet-ring cell carcinoma and mucinous adenocarcinoma were the most common types; highly and/or moderately differentiated carcinoma and tubular or papillary adenocarcinoma were most frequently observed in the patients older than 60, with a significant difference between the two age groups （P〈0.05）. Compared to that of the elder patients, the younger patients had higher expression of S100A4 and lower expression of nm23H1 （P〈0.05）. Among the younger patients, nm23H1 expression was lower in cases with serosa involvement than in cases without serosa involvement. In the younger patients, MMP-7 expression was higher in the highly and/or moderately differentiated cases than in the poorly differentiated cases, and S100A4 expression was higher in patients with lymph node metastasis than in patients without metastasis （P〈0.05）. Among the older patients, the nm23H1 expression level in the poorly differentiated carcinomas was lower than that in the highly and/or moderately differentiated carcinomas, heparanase expression was higher in patients with lymph node metastasis, and MMP-7 expression in patients with significant lymph node metastasis and small node fusion was higher than that in patients with less lymph node metastasis and large node fusion （P〈0.05）. Conclusion： The clinicopathological features of gastric cancer differ between younger and older patients. S100A4, MMP-7, heparanase and nm23H1 may be important genes that control the different biological behaviors in the two age groups. Examining the expression of these genes can contribute to an evaluation of the differentiation, infiltration and metastasis of gastric cancer.