TrkB、Survivin和Bcl-2在胃癌组织中的表达及意义

Expression and clinical significance of TrkB、Survivin and Bcl-2 in gastric carcinoma

[目的]探讨凋亡相关基因TrkB、Survivin和Bcl-2蛋白在胃癌组织中的表达及其与胃癌临床病理学参数的关系。[方法]采用免疫组织化学SP法检测76例原发性胃癌组织和癌旁正常组织TrkB、Survivin和Bcl-2蛋白的表达,并用原位末端标记法检测凋亡指数。[结果](1)胃癌组织中TrkB、Survivin和Bcl-2蛋白的阳性表达率分别为60.53%、73.68%和67.11%,明显高于癌旁正常组织(0.00%、17.11%和22.37%)。TrkB表达与胃癌浸润深度、淋巴结转移和TNM分期有关,Survivin表达与组织学分化、淋巴结转移、TNM分期有关,Bcl-2与组织学分化和TNM分期有关;(2)胃癌平均AI为(2.97±0.37),癌旁正常组织为(9.42±2.87),差异具有显著性意义(P<0.01);TrkB、Survivin和Bcl-2阳性组的AI明显低于阴性组(P<0.05);(3)胃癌组织中TrkB和Survivin的表达呈正相关(r=0.373,P=0.001),Survivin和Bcl-2的表达呈正相关(r=0.345,P=0.002),Bcl-2和TrkB的表达呈正相关(r=0.351,P=0.002);(4)COX比例风险模型分析提示TrkB、Survivin和临床分期与生存期负相关。[结论]TrkB、Bcl-2和Survivin蛋白异常表达而引起的失巢凋亡调控机制失常与胃癌发生与发展有关;TrkB、Sur-vivin和临床分期是胃癌独立的预后因素。

[Objective]To evaluate the expression and significance of TrkB,Bcl-2 and Survivin proteins in gastric carcinoma.[Methods]A series of 76 specimens of carcinoma tissues and 76 specimens of adjacent normal tissues were examined by S-P immunohistochemistry staining.Tumor cell apoptosis was tested by TUNEL method.[Results]（1） The positive frequencies of TrkB,Survivin and Bcl-2 in carcinoma tissues were 60.53%,73.68%and 67.11%,which were significantly higher than that in normal tissues（0%,17.11% and 22.37%,P〈0.05）.The positive rate of TrkB was related with invasive depth,histological grades and pathological stages.The positive rate of Survivin was related with histological grades,local lymph node metastasis and pathological stages.The positive rate of Bcl-2 was related with histological grades and pathological stages.（2） The AI in TrkB,Survivin and Bcl-2-positive carcinoma tissues were significant lower than in negative tissues（P〈0.05）;（3） The TrkB expression was positively correlated to Survivin（r=0.373,P=0.001）.The Survivin expression was positively correlated to Bcl-2（r=0.345,P=0.002）.The Bcl-2 expression was positively correlated to TrkB（r=0.351,P=0.002）.（4） Cox multivariate analysis showed that TrkB,Survivin and pathological stages were independent determinants of overall survival.[Conclusions]The unusual expression of TrkB,Survivin and Bcl-2 proteins was associated with anoikis,which induces the oncogenesis and progression of gastric carcinoma.TrkB,Survivin and pathological stages are independent predictor of poor clinical outcome for gastric carcinoma.