胃癌淋巴结转移相关因素的多元分析

A multianalysis study on clinicopathologic factors related to lymph node metastasis in gastric cancer

目的 探讨胃癌组织中CD44v6、基质金属蛋白酶 9(MMP 9)、金属蛋白酶抑制剂 1(TIMP 1)和结构型一氧化氮合酶 (cNOS)mRNA的表达等因素与胃癌侵袭转移的关系以及在预测胃癌淋巴结转移中的价值。方法 采用Logistic逐步回归的方法 ,对 119例原发性胃癌 10项与胃癌淋巴结转移有关的指标进行筛选。结果 胃癌组织中CD44v6表达越强 ,发生淋巴结转移的机率越高 ;MMP 9阳性表达而TIMP 1阴性表达者 ,发生淋巴结转移的机率最高 ;MMP 9阴性表达而TIMP 1阳性表达者 ,发生淋巴结转移的机率最低 ;胃癌血管或淋巴管内皮细胞cNOSmRNA阳性表达者 ,发生淋巴结转移的机率较高。结论 胃癌组织中CD44v6表达强度、MMP 9和TIMP 1表达失衡情况及胃癌血管或淋巴管内皮细胞cNOSmRNA的表达情况 ,可作为术前预测患者淋巴结转移的有效指标。

Objective To study the function of CD44v6, MMP 9, TIMP 1 and cNOS in the invasion and metastasis of gastric cancer and their value in estimating early lymph node metastasis.Methods Logistic stepwise regression model was used to analyze the influence of ten clinicopathological factors on the lymph node metastasis in 119 cases of gastric cancer.Results Using the established equation to estimate lymph node metastasis, the stronger the CD44v6 expression, the higher the frequency of lymph node metastasis; the frequency of lymph node metastasis was the highest in patients with positive MMP 9 and negative TIMP 1 expression. However, the frequency was the lowest in those with negative MMP 9 and positive TIMP 1 expression and that of positive expression in hemangio lymphangio endothelial cells of gastric cancer was relatively high.Conclusions The intensity of CD44v6 expression, the imbalance between MMP 9 and TIMP 1 expressions and cNOS mRNA expression in the endothelial cells were highly useful for the preoperative diagnosis of lymph node metastasis in gastric cancer patients. [