netrin-1蛋白在胃癌组织中的表达与临床病理及预后的关系

netrin-1 Protein Expression in Gastric Cancer and Its Correlation with Clinicopathologic Features and Prognosis

目的探讨胃癌netrin-1蛋白的表达与胃癌患者临床病理和预后的关系。方法应用组织芯片和免疫组化技术,分析胃癌和癌旁组织中netrin-1蛋白和Ki67的表达,对其表达进行相关分析并探讨其与临床病理特征的关系。采用Kaplan-Meier限乘法计算生存率。建立Cox回归模型,评价netrin-1蛋白作为胃癌患者预后的独立影响因素的可行性。结果在67例胃癌和癌旁组织中,netrin-1蛋白的阳性表达率分别为49%和42%。在不同性别、肿瘤直径和分化程度的患者之间,胃癌组织细胞中netrin-1表达差异无统计学意义(P>0.05)。但在不同浸润深度、淋巴转移和远处转移的患者之间,差异有统计学意义(P<0.05)。胃癌组织netrin-1阳性表达不同程度在远处转移的患者之间,差异有统计学意义(P<0.05)。胃癌中Ki67的阳性表达率为60%。Ki67的表达与临床病理特征之间未见相关性(P>0.05)。胃癌中netrin-1蛋白和Ki67的表达之间存在正相关关系(r=0.359,P<0.05)。用Kaplan-Meier生存曲线经log-rank检验发现,netrin-1蛋白的阳性表达以及阳性表达不同程度与生存相关(P<0.05)。netrin-1蛋白的表达与胃癌患者预后无明显相关性(RR=1.335,95%CI:0.612～2.914)。结论 netrin-1蛋白参与了胃癌的发生发展,与增殖密切相关,检测netrin-1蛋白的表达可作为反映胃癌临床病理学特点和患者生存期的指标,但netrin-1蛋白的表达不是胃癌患者预后的独立影响因素。

Objective To evaluate the relationship between netrin-1 protein,clinicopathologic features and prognosis in gastric cancer patients.Methods Tissue micro-array and immunohistochemistry were used to detect expression of netrin-1 protein and Ki67.And clinicopathological relevance of netrin-1 protein and Ki67 in gastric cancer were analyzed.Survival rates was evaluated by Kaplan-Meier survival curves.Cox regression analysis was performed to evaluate the possibility of netrin-1 expression as an independent prognostic factor for gastric cancer.Results The positive-expression rate of netrin-1 protein,paracancerous netrin-1 protein and Ki67 in tumor tissue from 67 patients with gastric cancer were 49%,42% and 60%,respectively.netrin-1 protein expression might be related to depth of invasion,lymth node metastasis and distant metastasis（P0.05）.But no correlation was observed in sex,tumor diameter and tumor grade（P0.05）.There was correlation between different degrees of netrin-1 expression and distant metastases（P0.05）.No correlation was found in the expression of Ki67 and clinicopathological features.The correlation between the expression of netrin-1 and Ki67 was observed（r=0.359,P0.05）.Using Kaplan-Meier survival curves and the log-rank test,the correlation of netrin-1 expression,different degrees of netrin-1 expression and survival（P0.05） were also observed.But netrin-1 expression was not significantly correlated with the prognosis of gastric cancer（RR=1.335,95%CI：0.612-2.914）.Conclusion netrin-1 protein may be related with tumorigenesis and tumor progression by affecting proliferation.The detection for netrin-1 may be helpful to evaluate the clinicopathological parameters and survival time.However,it is not an independent prognostic factor for gastric cancer.