化疗对胃癌SPARC表型的影响

Effect of chemotherapy on the phenotype of secreted protein, acidic and rich in cysteine in gastric cancer

目的:本研究旨在探讨化疗对胃癌SPARC(secreted protein,acidic and rich in cysteine)表型的影响。方法:免疫组织化学方法检测132例胃癌组织中SPARC的表达情况。132例胃癌组织中,54例取自新辅助化疗后手术胃癌患者,78例取自无新辅助化疗手术的胃癌患者,以免疫组织化学方法检测各例组织标本中SPARC的表达,分析化疗对SPARC表型影响。结果:较正常胃组织及肿瘤细胞周围的间质组织,SPARC在胃癌细胞中高表达;SPARC高表达与肿瘤浸润深度、淋巴结转移和TNM分期相关。新辅助化疗组的SPARC高表达比例较无新辅助化疗的对照组低(P<0.05)。单因素分析表明大体类型、组织学类型、浸润深度、淋巴结转移、TNM分期、新辅助化疗后SPARC表型表达为新辅助化疗后手术组胃癌患者的预后影响因子;多因素分析表明淋巴结转移、组织学类型、新辅助化疗后SPARC表型表达为独立的预后影响因子。结论:SPARC表达与肿瘤浸润深度、淋巴结转移、TNM分期及胃癌患者预后相关;新辅助化疗可改变胃癌SPARC表型。

Objective：To investigate the influence of chemotherapy on the phenotype of secreted protein, acidic and rich in cysteine （SPARC） in gastric cancer （GC）. Methods：Immunohistochemistry was used to analyze SPARC expression in 132 GC patients. Among these patients, 54 with preoperative chemotherapy and 78 without preoperative chemotherapy were selected to analyze the effect of chemotherapy on SPARC phenotype by comparing the postoperative specimens of the two cohorts. Results：SPARC expression was higher in GC lesions than in the desmoplastic stroma surrounding the tumor cells and noncancerous tissues. High SPARC expression was related to invasion depth, lymph node metastasis, and TNM staging. SPARC expression was lower in patients with preoperative chemotherapy than in controls （ P〈0.05）. Gross type, histology, depth of invasion, lymph node metastasis, TNM staging, and SPARC phenotype correlated with the overall survival of the patients with preoperative chemotherapy. Further multivariate analysis suggested that lymph node metastasis, histology, and SPARC phenotype after chemotherapy were independent prognostic indicators of GC. Conclusion：SPARC expression was associated with invasion depth, lymph node metastasis, TNM staging and GC prognosis. Preoperative chemotherapy may change the phenotype of SPARC in GC patients.