胃癌组织MIC-1与uPA蛋白表达及其与侵袭转移和预后关系的探讨

Expressions of MIC-1 and uPA and their prognostic significance in gastric carcinama tissues

目的:研究巨噬细胞抑制因子-1(MIC-1)和尿激酶型纤溶酶原激活物(uPA)表达对胃癌的预后意义。方法:用免疫组织化学SP法测定76例胃癌组织石蜡标本中MIC-1和uPA蛋白的表达水平,并分析其与临床病理因素的关系及其中46例患者的预后意义。结果:MIC-1及uPA蛋白在76例胃癌组织的阳性表达率为68.42%(52/76)和67.11%(51/76),其中侵及浆膜的分别为93%、83%,有淋巴结转移的分别为86%、90%,临床分期为Ⅲ+Ⅳ期的分别为85%、83%,其阳性表达率明显高于未侵及浆膜组(25%,χ2=38.685,P=0.000;39%,χ2=15.543,P=0.000)、无淋巴结转移组(45%,χ2=14.238,P=0.000;36%,χ2=24.971,P=0.000)及临床分期为Ⅰ+Ⅱ期组(41%,χ2=15.871,P=0.000;41%,χ2=14.060,P=0.000)。而在不同性别、年龄、肿瘤部位、肿瘤大小、Borrmann分型、病理分化程度的阳性表达差异无统计学意义,P>0.05。MIC-1及uPA蛋白表达与胃癌患者预后呈负相关,MIC-1和uPA共表达比检测其中单一指标更具预后判断价值。结论:MIC-1和uPA蛋白在胃癌组织中的表达与胃癌侵袭转移关系密切,可以作为反映胃癌生物学行为和判断预后的有效指标。

OBJECTIVE： To investigate the ralationship between the expressions of macrophage inhibitory cytokine-1 （MIO1） and urokinase-type plasminogen activator （uPA） and their prognostic significance in gastric carcinoma （GC）. METHODS：The immunohistochemistry method （SP） was used to determined the immunoreacticity to MIC1 and uPA antibodies in 76 GC specimens, and 46 patients were followed up. RESULTS： In 76GC specimens, the expressions of MIC-1 and uPA protein were observed in 52 （68.42%） cases and 51 （67.11%） cases respectively. The positive expression rates in serosa invasion cases （93 %, 83%）, lymph-node metastasis （86%, 90%） and stage Ⅲ＋Ⅳ （85%, 82%） were significantly higher than those of non-serosa invasion （25%, X^2=38.685, P=0.000; 39%, X^2 = 15.543, P= 0.000）, non-lymph-node metastasis （45%, X^2 = 14. 238, P=0. 000; 36%, X^2 =24. 971, P=0. 000） and stage Ⅰ＋Ⅱ（41%, X^2 =15. 871, P= 0. 000; 41%, X^2=14. 060, P=0. 000）, but there were no statistically significant differences in the expressions of MIC-1 and uPA among （between） the different ages, sexes, tumor sizes and locations, and gross morphology and pathology histological grades （P〉0.05）. The expression levels of both MIC-1 and uPA were negatively correlated with gastric carcinoma prognosis, and the combination of the two markers were more valuable than either in prognosis prediction. CONCLUSIONS： Overexpressions of MIC-1 and uPA in patients with GC can enhance the possibility of invasion and metastasis, implying poor prognosis. They may serve as fairly good prognostic factors to indicate biologic behavior and prognosis in GC.