贲门癌组织乙酰肝素酶和YY1蛋白表达及其与预后的关系

The expression and prognosis of Heparanase and Protein YY1 in gastric cardia adenocarcinoma(GCA)

目的研究乙酰肝素酶(HPA)和YY1蛋白(YY1)在贲门癌组织中表达特征及其与患者预后的关系。方法采用组织病理学和免疫组织化学(ABC)法检测HPA和YY1蛋白在45例贲门癌组织中的表达,所有贲门癌组织均来自林州市中心医院,并对患者随访5a以上。结果 45例贲门癌组织HPA阳性表达率为56%(25/45),YY1阳性表达率为22%(10/45);HPA表达阳性和阴性组食管癌患者的平均生存时间及95%的可信区间分别为44(35,52)mon和60(56,64)mon,HPA表达阳性患者生存期显著小于阴性表达者(P<0.05);YY1蛋白表达阳性和阴性组患者的平均生存时间及95%的可信区间为54(43,66)mon和50(44,57)mon,YY1蛋白表达阳性患者生存期大于阴性表达者,但无明显统计学意义(P>0.05);多因素Cox模型逐步回归分析结果显示淋巴结转移对患者的影响最大。结论 HPA和YY1阳性表达对患者生存期有一定的影响,但不是贲门癌独立的预后指标,淋巴结转移是贲门癌独立的预后指标。

Objective To characterize the expression and prognosis of heparanase and protein YY1 in gastric cardia adenocarcinoma （GCA）. Methods Histopathological analysis and immunohistochemical staining （ABC） were applied to detect the expression of heparanase and protein YY1 on 45 cases in GCA. All the tissues of GCA were from Central Hospital of Linzhou and were followed up more than 5 years after surgery. Results The positive expression rate for heparanase was 56 % （25/45）and for YY1 was 22%（10/45） in GCA. The mean survival periods and 95% confidence interval for those with positive and negative expression of heparanase were 44 （35,52）and 60 （56,64） months, respectively. Patients with positive expression for heparanase survived obviously less than those with negative expression, and the difference was significant （P〈0.05）. The mean survival periods and 95% confidence interval for those with positive and negative expression of protein YY1 were 54 （43,66）and 50 （44,57） months, respectively. There was no significant difference between positive and negative expression in mean survival periods for YY1 （P 〉 0.05）. Stepwise multivariate analysis showed that lymphatic metastasis was the most important factor affecting the prognosis of GCA （P 〈0. 05）. Conclusion The expression of heparanase and YY1 is related with mean survival periods in GCA, but may be not independent prognostic indicators for poor prognosis of GCA. lymphatic metastasis is one of the most important independent factors in the prognosis of GCA.