差别PCR技术检测胃癌C一erbB-2癌基因扩增的临床意义

The clinical sigaificance of differential polymerase chain reaction of C-erbB-2 oncogene amplification in gastric cancer

目的探讨胃癌Ｃ－ｅｒｂＢ－２癌基因扩增的临床意义。方法应用差别ＰＣＲ技术检测Ｃ－ｅｒｂＢ－２在８３例胃癌及１０１个转移淋巴结扩增情况。结果２８．９％（２４／８３）的胃癌存在该基因扩增，进展期胃癌及伴淋巴结转移者扩增阳性率增高（Ｐ＜０．０５及Ｐ＜０．０１）；转移淋巴结扩增阳性率明显高于胄癌原发灶（Ｐ＜０．０５）。早期胃癌及高中分化胃癌伴Ｃ－ｅｒｂＢ－２扩增者５年生存率低于不扩增者（Ｐ＜０．０５）。用Ｓｏｕｔｈｅｒｎｂｌｏｔ分子杂交及免疫组化ＡＢＣ法检测原胃癌样本基因扩增及过度表达，扩增及过度表达率分别为１５．７％及１８．１％，均明显低于上述扩增阳性率。结论差别ＰＣＲ技术检测Ｃ－ｅｒｂＢ－２扩增是一种快速方便、可靠、独立的方法，对胃癌预后及转移潜力是一种良好的判断指标。

Objective To assess the clinical significance of C-erbB-2 oncoge- ne amplification in gastric cancer. Methods C-erbB-2 oncogene amplification was examined by using differential polymerase chain reaction(dPCR) in 83 cases of gastric cancer and 101 lymph nodes metastasis. Results C-erbB-2 amplification was found in 28.9 %( (24/83) patients and was significant in cases of advanced cancer (P<0. 05) and those with lymph node metastasis (P< 0.01). The incidence of C-erbB-2 amplification in lymph nodes metastasis was higher than that in primary sites (P <0.05). The patients with amplification had lower rates of 5-year survival than those with non-amplified ones in early cancers well-and to moderately differentiated adenocarcinomas (P<0.05). The same samples were tested again by Southern blot hybridization to ascertain C-erbB-2 aznplification and immunohistochemical reactivi- ty to C-erbB-2 protein. The rates of C-erbB-2 amplification and protein overexpression (15.7 % and 18.1 % respectively) were lower than the above, amplified by dPCR. Conclusion C-erbB-2 amplification test by dPGR is quick, simple, and reliable method, also an independent prognostic marker for predicting the prognosis and metastatic potential of gastric cancer.