胃癌组织中Ets-1的表达及其与血管生成临床病理特征和预后的关系

Relationship between Ets-1 expression and angiogenesis, clinicopathological features and survival of patients with gastric carcinoma

目的探讨胃癌组织、癌旁组织及淋巴结转移灶中Ets-1表达的临床意义，分析Ets-1表达与血管生成、临床病理特征及预后的关系。方法应用免疫组化sP法，采用组织芯片技术，检测189例胃癌组织、54例癌旁组织、41例淋巴结转移灶及32例正常胃黏膜中Ets-1蛋白的表达。对胃癌患者通过上门或电话进行问卷随访。结果胃癌组织、癌旁组织和正常胃黏膜Ets-1的阳性表达率分别为71．4％、29．6％和18．8％，3组间差异有统计学意义（P〈0．01）。135例Ets-1表达阳性的胃癌组织微血管密度（MVD）为30．42±15．21，54例Ets-1表达阴性的胃癌组织MVD为25．73±11．50，两组差异有统计学意义（P=0．042）。Ets-1蛋白表达与浸润深度、淋巴结转移有关（P〈0．01），与性别、年龄、肿瘤大小、分化程度、Lauren分型无关（P〉0．05）。41例淋巴结转移灶和相对应的41例胃癌组织Ets-1表达阳性率分别为84．4％和58．5％，差异有统计学意义（P=0．007）。单因素分析显示，Ets-1表达对胃癌患者生存期的影响有统计学意义（P〈0．05），Cox多元回归分析显示，Ets-1表达不是胃癌患者预后的独立影响因素（P〉0．05）。结论Ets-1在促进胃癌血管生成中发挥着重要作用，在胃癌的发生、发展中扮演了重要角色，Ets-1表达对胃癌患者的生存期有一定影响，胃癌淋巴结转移灶和原发灶肿瘤组织中Ets-1的表达不同，具有异质性。

Objective To investigate the expression of Ets-1 in gastric carcinoma, para-cancerous tissue and metastatic lymph nodes, and to determine the relationship between Ets-1 expression and clinicopathological features, angiogenesis and survival of patients with gastric carcinoma. Methods Gastric carcinoma tissue microarray was used to determine Ets-1 protein expression by SP immunohistochemical staining in 189 advanced gastric cancer, 54 papacancerous tissues,41 metastatic lymph nodes and 32 control tissues. Results The positive rates for Ets-1 expression of the carcinoma, paracancerous and control tissues were 71.4 %, 29.6% and 18.8%, respectively, with a significant difference among the three groups （P 〈 0.01 ）. In the cancer tissues, the positive rate of Ets-1 protein expression was significantly associated with depth of invasion and lymph node metastasis （P 〈 0.01 ）, but not associated with degree of differentiation, Lauren＇s histological type, sex, age, and size of tumor （P 〉 0.05 ）. The positive rates for Ets-1 expression of the 41 gastric cancer and 41 metastatic lymph nodes were significantly different （P 〈 0.05 ）. In metastatic lymph nodes, the positive rate for Ets-1 expression was higher. The MVD in Ets-1 positive tumors was higher than that in the Ets-1 negative tumors, with a significant difference （ P 〈 0.05 ）. Kaplan-Meier survival analysis showed that the survival time of Ets-1 -negative patients was longer than that of Ets-l-positive patients （P 〈 0.05 ）. Cox regression analysis showed that Ets-1 expression was not an independent prognostic factor of gastric carcinoma. Conclusion A higher expression of Ets-1 is involved in carcinogenesis, development,invasion, and metastasis of gastric cancer. Ets-1 plays an important role in angiogenesis in gastric cancer. Ets-1 is a useful marker for predicting the outcome for patients with gastric carcinoma, though it is not an independent prognostic indicator.