粘膜内和粘膜下胃癌中Cyclin E表达的变化及意义

THE VARIATIONS OF CYCLIN E EXPRESSION AND ITS SIGNIFICANCE IN MUCOSA AND SUBMUCOSA LAYER GASTRIC CANCERS

目的探讨浸润加深时早期胃癌中ＣｙｃｌｉｎＥ的表达变化及其意义。方法用免疫组化法检测５７例粘膜层和５１例粘膜下层胃癌中ＣｙｃｌｉｎＥ及ｐ５３的表达。结果ＣｙｃｌｉｎＥ的强阳性率为粘膜内癌０％（０／５７），粘膜下癌１８％（９／５１）（Ｐ＜００５）。在粘膜层胃癌：ＣｙｃｌｉｎＥ的阴性和低表达组间几乎所有的观察指标均无明显差异。在粘膜下层胃癌：ＣｙｃｌｉｎＥ高表达率在ｐ５３阳性者为３８％（８／２１），侵入淋巴管者２９％（９／３１），侵入淋巴结者４０％（４／１０），都显著或倾向高于对照组。ＣｙｃｌｉｎＥ高表达组的五年生存率３３％（３／９），显著低于非高表达组者。结论胃癌由粘膜内侵入粘膜下层时，ＣｙｃｌｉｎＥ的表达增强。ＣｙｃｌｉｎＥ高表达的粘膜下层胃癌恶性度高，须采取更积极治疗措施。

PURPOSE To investigate the variations of cyclin E expression and its significance in early gastric cancer as invasion depth increasing.METHODS The expressions of cyclin E and p53 were examined by immunohistochemical method in 57 mucosa and 51 submucosa layer gastric cancers.RESULTS The cyclin E strongly positive rates were 0(0/57) in the gastric cancers within mucosa layer and 18%(9/51) in those invading into submucosa layer ( P <0.05).In mucosa layer gastric cancers,almost all the observed indexes did not show significant difference between cyclin E negative and positive groups. In submucosa layer gastric cancers,the cyclin E strongly positive rates were as follows:p53 positive cancers,38%(8/21);those with lymphatic vessel invasion,29% (9/31);those with lymph node metastasis,40%(4/10);being significantly or nearly significantly higher than control groups.The strongly positive patients had a 5 year survival rate of 33%(3/9),being significantly lower than non strongly positive groups.CONCLUSION The expression of cyclin E enhanced as gastric cancer invaded from mucosa into submucosa layer.The submucosa layer gastric cancers with strongly positive expression of cyclin E have a high malignancy,this kind of patients should be given more active treatments.