Ki-67抗原表达与胃癌病理生物学行为关系的研究

Study of the relationship between the expression of Ki 67 antigen and the pathobiological behaviours of stomach cancer

目的探讨Ｋｉ－６７抗原与胃癌病理生物学行为的关系，特别是与远隔脏器转移行为的关系。方法应用ＡＢＣ免疫组化法，检测５６例胃癌手术标本经甲醛固定、石蜡包埋的常规病理切片的Ｋｉ－６７抗原表达，以Ｋｉ－６７抗原表达阳性数评估胃癌组织的增殖活性。结果Ｋｉ－６７抗原表达量与胃癌组织学类型、分化程度、生长方式、胃壁浸润深度以及区域淋巴结转移无明显相关（Ｐ＞０．０５），但与胃癌的肝、卵巢、肾上腺等远隔脏器的转移呈明显正相关（Ｐ＜０．００５）。此外还发现，Ｋｉ－６７抗原表达量与胃癌组织的ＤＮＡ异倍体和突变型ｐ５３基因产物表达呈明显正相关（Ｐ＜０．０５）。结论Ｋｉ－６７抗原作为一个代表增殖活性的肿瘤标志，其过量表达与胃癌的恶性生物学行为，特别是远隔脏器转移行为密切相关，故有可能应用于临床，以估计胃癌的预后和判断远隔脏器转移的危险性。ｐ５３基因可能通过基因突变增加胃癌细胞的增殖活性，使Ｋｉ－６７抗原表达量明显增加，并导致ＤＮＡ异倍体类型的增加。

Objective To evaluate the relationship between the expression of Ki 67 antigen and the pathobiological behaviours of stomach cancers especially their distant metastases. Methods 56 stomach cancer specimens routinely fixed in formalin and embeded in paraffin (FFEP) were studied by immunohistochemical method. Results Expression of Ki 67 antigen was significantly related to the distant metastases to liver, ovary and adrenal gland ( P <0.005); but not related to the histological type, growth pattern, depth of invasion, histological differentiation and the metastases to local lymph nodes ( P >0.05). Furthermore, the Ki 67 expression was significantly related to the DNA anueploid pattern and the expression of p53 protein, both of which are closely related to poor prognosis.Conclusion Overexpression of Ki 67 can be used as an objective marker of the proliferative activity for predicting prognosis of stomach cancer and to foretell the high risk of metastasis to distant organs.