食管胃结合部腺癌组织中胃泌素受体表达及其临床意义

Expression and clinical significance of gastrin receptor in adenocarcinoma of esophagogastric junction

目的 探索食管胃结合部腺癌组织中胃泌素受体的表达及其临床意义.方法 收集汕头大学医学院附属肿瘤医院2011年10月至2014年6月行食管胃结合部腺癌根治术患者120例,男101例,女19例;年龄40 - 82岁,中位年龄64岁.应用免疫组织化学技术检测手术切除癌组织和相邻正常胃黏膜胃泌素受体的表达情况.分析胃泌素受体表达与临床病理因素的相关性.结果 120例患者中,癌组织胃泌素受体阴性18例,弱阳性39例,中阳性47例,强阳性16例;正常胃黏膜组织中,胃泌素受体表达多为阴性或弱阳性,仅19例为中阳性.胃泌素受体表达与患者性别、年龄、吸烟、饮酒、肿瘤细胞分化程度及pT分级等无明显相关性（P＞0.05）.胃泌素受体表达阳性在pN分级0、1-3级患者中分别为32.3％ （10/31）、59.6％（53/89）,在pTNM分期Ⅰ-Ⅱ、Ⅲ期患者中分别为34.6％（9/26）、57.4％（54/94）,胃泌素受体表达与pN分级及pTNM分期呈正相关（P＜0.05）.结论 胃泌素受体在食管胃结合部腺癌组织中表达率较高,并且随着肿瘤的进展胃泌素受体表达率也升高,有望成为食管胃结合部腺癌的一个治疗靶点.

Objective To investigate the expression and the clinical significance of gastrin receptor in adenocarcinoma of esophagogastric junction （AEG）.Methods Totally 120 AEG patients confirmed by pathology who underwent surgical resection from October 2011 to June 2014 were collected.Immunohistochemistry was used to assess the expression of gastrin receptor in tumor tissue and adjacent normal tissue.The correlation between gastrin receptor expression and clinicopathologic features was analyzed.Results Of the 120 patients with AEG,gastrin receptor in tumor tissue was negatively expressed in 18 cases,weakly positively expressed in 39 cases,moderately positively expressed in 47 cases,and strongly positively expressed in 16 cases;most of normal tissue showed negative or weakly positive expression of gastrin;only 19 showed moderately positive expression of gastrin receptor.The expression of gastrin receptor was not significantly different between male and female,≤60 and 〉60 years old,smokers and non smokers,alcohol users and non alcohol users,pT grade 1-2 and 3-4 patients;there were no significant differences among patients with low,moderate and high differentiation of tumor （P 〉 0.05）.The expression of gastrin receptor was significantly different between pN grade 0 and 1-3 patients [32.3% （10/31） vs 59.6% （53/89）],and between pTNM stage Ⅰ-Ⅱ and Ⅲ patients [34.6% （9/26） vs 57.4% （54/94）] （P =0.05）.Conclusion Gastrin receptor is over-expressed in AEG and the expression level is increased with tumor progression.