胃腺癌组织中Runx3、Smad4与p21的表达及临床意义

The expressions of Runx3,Smad4 and p21 in gastric adenocarcinoma and clinical significance

目的研究胃腺癌及非癌组织中Runx3、Smad4和p21的表达及临床意义。方法收集130例胃腺癌患者手术切除标本制作的石蜡块共378份，其中癌组织130份，癌旁组织和非癌组织248份，每份组织制成4块组织芯片，分别为174点、282点、156点和156点。采用免疫组化法检测其中Runx3、Smad4和p21的表达。结果Runx3在胃腺癌中的异常表达率高于非癌组织（P〈0．05），Smad4及p21的异常表达在胃黏膜癌变过程中呈上升趋势（P〈0．05）。Runx3的异常表达与胃腺癌组织学分化程度和淋巴结转移有关（P〈o．05）。Smad4和p21的异常表达均与胃腺癌的分化程度相关（P〈0．05）。胃腺癌中Runx3表达与Smad4和p21表达呈正相关（r=0．387，P〈O．05；r=0．840，P〈O．05）。Runx3、Smad4、p21正常表达患者的3年生存率均大于异常表达患者（P〈0．05）。多因素分析显示，Runx3和Smad4的表达可作为胃腺癌患者独立的预后因素（P〈0．05）。结论Runx3、Smad4和p21在胃腺癌的发生、发展中可能起一定的作用。Runx3和Smad4可作为判断胃腺癌患者预后的指标之一。

Objective To investigate the expressions of Runx3,Smad4 and p21 in human gastric adenocarcinoma and non cancerous tissues and the clinical significance. Methods Three hundred and seventy eight paraffin embedded blocks prepared from surgical samples of 130 patients with gastric adenocarcinoma consisted of 130 cancerous blocks and 248 non cancerous blocks. Four tissue microarrays （174 dots, 282 dots, 156 clots and 156 dots） were made for each block. The expressions of Runx3, Smad4 and p2t were detected by immunohistochemistry. Results The abnormal expression of Runx3 was higher in cancerous tissues than in non-cancerous tissues （P〈 0. 05）. The aberrant expressions of Smad4 and p21 were increased gradually in the process of gastric carcinogenesis. The aberrant expression of Runx3 was associated with tumor differentiation and lymph node metastasis （P〈0. 05）. Whereas the expressions of Smad4 and p21 were closely related to the tumor differentiation （P〈 0. 05）. The aberrant expression of Runx3 was positively correlated with the abnormal expressions of Smad4 and p21 （r=0. 387,P^0.05;r--0. 840,P%0. 05, respectively）. Kaplan-Meier analysis showed that the 3-year survival rate in patients with normal expressions of Runx3, Smad4 and p21 was significantly higher than that in patients with abnormal expressions （P〈0. 05）. Furthermore, multivariate analysis indicated that Runx3 and Smad4 expressions were independent prognostic factors for patients with gastric cancer （P〈0.05）. Conclusions The Runx3, Smad4 and p21 may involve in the carcinogenesis of gastric adenoearcinoma. Runx3 or Smad4 may be one of the index in prognosis of patients with gastric adenocarcinoma.