性激素受体在胃癌同时性卵巢转移中的表达及意义

Expression of sex hormone receptor in gastric cancer with synchronous ovarian metastasis and its significance

目的 探讨胃癌同时性卵巢转移的临床病理特点及性激素受体的表达意义.方法 回顾性收集安徽医科大学第一、第三附属医院2002年1月至2012年12月经病理及免疫组织化学证实的胃癌同时性卵巢转移31例为试验组,采用免疫组织化学方法对胃癌原发灶及卵巢转移灶癌组织中雌激素受体α（ERα）、雌激素受体β（ERβ）、孕激素受体（PR）及雄性激素受体（AR）的表达进行检测,并完全随机法选取同时期同医院31例无卵巢转移的女性胃癌作为对照组,结合临床病理资料分析.结果 试验组胃癌原发灶与对照组胃癌在年龄、是否绝经、胃癌大体分型、病理类型、分化程度、侵犯浆膜、腹膜种植、脉管癌栓方面差异均有统计学意义（均P＜0.05）.ERα、ERβ、PR及AR在试验组胃癌原发灶组织中的阳性表达分别为15例（48.4％）、12例（38.7％）、13例（41.9％）、10例（32.3％）,在对照组胃癌组织中的阳性表达分别为7例（22.6％）、20例（64.5％）、5例（16.1％）、13例（41.9％）,两组比较ERα、ERβ、PR的阳性表达率差异有统计学意义（均P＜0.05）.试验组胃癌原发灶组织中ERα、ERβ、PR之间相关性分析示：ERα与PR表达呈正相关（P＜0.01）,余两者间均无相关性（均P＞0.05）.结论 胃癌细胞中ERα、PR的表达增强以及ERβ的表达缺失可能是胃癌发生同时性卵巢转移的重要原因.

Objective To explore the clinicopathological characteristics of gastric cancer with synchronous ovarian metastasis and the significance of expression of sex hormone receptors.Methods We retrospectively collected 31 cases of gastric cancer with synchronous ovarian metastasis from January 2002 to December 2012 from First and Third Affiliated Hospitals,Anhui Medical University as the test group.Then the expressions of estrogen receptor alpha （ERα）,estrogen receptor beta （ERβ）,progesterone receptor （PR） and androgen receptor （AR） in primary and metastatic lesions were detected by pathology and immunohistochemistry.Meanwhile 31 female gastric cancer patients without ovarian metastasis during the same period and at the same hospital designated as the control group.And their clinicopathological data were analyzed.Results As compared with the control group,the primary lesions of the test group had significant differences in age,tumor gross type,pathological type,degree of differentiation,depth of tumor invasion,peritoneal implantation and vascular thrombosis （all P 〈 0.05）.The expressions of ERα,ERβ,PR and AR in primary tumors of the test group were 48.4% （n =15）,38.7% （n =12）,41.9% （n =13）,32.3% （n=10） versus22.6% （n=7）,64.5% （n=20）,16.1% （n=5） and41.9% （n=13） in the control group.The expressions of ERα,ERβ and PR in two groups were statistically significant（all P 〈 0.05）.The expressions of ERα and PR were positively correlated （P 〈 0.05） while there was no correlation between the others in test group （both P 〉 0.05）.Conclusion The strengthened expressions of ERα and PR and a missing expression of ERβ may be a crucial factor in gastric carcinogenesis with synchronous ovarian metastasis.