PCNA在进展期胃癌中表达及与预后关系的研究

Proliferating Cell Nuclear Antigen in Advanced Gastric Cancers and Relationship with Prognosis

目的 :用针对细胞增殖核抗原 (proliferatingcellnuclearantigen ,PCNA)的抗体检测进展期胃癌细胞的增殖活力 ,探讨其表达及与预后的关系。方法 :用免疫组织化学方法测定了 157例内窥镜活检标本和其中 10例手术切除标本及 10例正常胃粘膜标本的PCNA标记指数 (Lablingindex ,LI)。结果 :PC NA在肿瘤的增殖细胞和正常胃粘膜腺体颈部细胞的核内强染色。PCNALI正常胃粘膜为 3 5%～10 6% ( 6 5± 3 4 ) % ,胃癌活检组织 12 6%～ 68 0 % ( 34 2± 10 7) % ,P <0 0 1。在肝脏和淋巴结转移、浆膜侵犯、腹腔播散、肿瘤大于或等于 6cm和组织学分化差的胃癌PCNALI明显增高 (P <0 0 1)。高PCNALI(≥ 35% ) 5年生存率明显低于低PCNALI( <35% )者 (P <0 0 1)。结论

Objective:That proliferrative activity, as measured by using monoclonal antibody against proliferative cell nuclear antigen(PNCA), is used in advanced gastric cancers and relationship with prognosis.Methods:PCNA labeling index(LI) was quantified by immunohistochemistry on formalih fixed paraffin embedded biopsy or surgically resected specimens from 157 patients with advanced gastric cancer and from 10 normal gastic mucosa.Ruesults:Immunohistochemic analysis has demonstrated that PCNA reveals an intensive staining in the nuclear of tumor cell and mucosal neek cells of gastic glands. PCNA LI ranged from 3.5 to 10.6%(6 5+3 4)%,in normal gastic mucosa, 12.6%-68.0%(34.2±10.)7% in endoscopic biopsy of advanced gastric cancer(P<0.01). There was a siginficant correlation between PCNA LI of biopsy and that of resected specimens of gastic cancer(γ=0.970 2,P<0.01). PCNA LI was significantly higher(P<0 01) in slices of tissues from liver and lymphotic metastasis, scrosal invasion, peritoneal metastasis, tumor size≥6cm and histologically poorly differentiated tomors. The 5 Yr Survival rate of patients with high PCNA LI(≥35) was significantly poor(P<0.01)than those with low LI(<35%).Conclusins:When the PCNA LI and pathologic factors were analyzed by the Cox Regression Model, PCNA LI emerged as an important and independent prognostic indicator.