诱导型一氧化氮合酶在进展期胃腺癌介入化疗后的临床意义

The clinic significance of inducible nitric oxide synthase in advanced gastric adenocarcinoma after interventional chemotherapy

目的探讨介入化疗后进展期胃腺癌细胞中诱导型一氧化氮合酶、凋亡、增殖、树突状细胞浸润的变化,并分析其临床意义。方法通过对术前行介入化疗的病人(介入组,56例)和直接进行手术根治的病人(对照组58例)术后肿瘤组织细胞中诱导型一氧化氮合酶(iNOS)、树突状细胞标志蛋白S-100(树突状细胞密度,DCS)的表达、细胞增殖核抗原Ki-67-LI的表达,原位末端标记技术TUNEL法检测胃腺癌细胞凋亡比例(AI),了解两组间iNOS、DCS、AI、Ki-67-LI的差别。结果介入组在有淋巴结转移者的iNOS阳性表达率为66.7%(12/18),高于淋巴结无转移者18.2%(4/22),两者差异有显著性意义(P=0.042)。介入组iNOS阳性表达率为28.6%(16/56),对照组iNOS阳性表达率为55.2%(32/58),两者差异有显著性意义(P=0.004)。DCs浸润的密度范围(1-50)/mm^2,平均为(6.09±5.36)/mm^2。对照组DCs(10.05±8.819)/mm^2高于介入组DCs(6.09±5.361)/mm^2,两者差异有显著性意义(P=0.005)。在两组中没发现AI、Ki-67-LI差异有显著性。结论iNOS的阳性表达促进进展期胃癌患者转移,而介入化疗后iNOS阳性表达明显下降,推测iNOS表达可评价化疗效果。

Objective To explore the effect of interventional chemotherapy on inducible nitric oxide synthase（iNOS） ,dendritic cells , apoptosis and proliferation in advanced gastric adenocarcinoma. And the clinic significance of them was evaluated. Methods The inducible nitric oxide synthase , density of dendritic cells and label index of Ki-67 of 56 patients accepted interventional chemotherapy prior to curable operation （interventional chemotherapy group） and 58 patients underwent operation directly （control group）were detected by immunohistochemical method. Apoptosis in advanced gastric adenocarcinoma were detected by TUNEL method. Results The positive expression rate of iNOS was 66.7% in metastatic cases of interventional chemotherapy group, which was higher than that of non-metastatic cases （18.2%） ,it was significant （P =0. 042）. The positive expression rate of iNOS in interventional chemo- therapy group was 28.6%, the positive expression rate of iNOS in control group was 55.2%, it was significant （P = 0.004）. The density of DCs of control group was higher than that of interventional chemotherapy group （P = 0.005 ）. The authors failed to find a significant correlation between the apotosis and Ki- 67-LI in two groups. Conclusion The positive expression of iNOS may contribute to metastasis. And the positive expression of iNOS in interventional chemotherapy group obviously reduced. The positive expression of iNOS could be correlated with chemotherapeutic effect.