细胞核内β-连环素表达水平在胃癌中的临床研究

The Clinical Studies of β- catenin Expression Levels in The Nucleus of Gastric Cancer

目的：探讨细胞核内β-连环素表达水平与胃癌临床病理因素的关系。方法：应用免疫组织化学SP法检测77例胃癌组织及30例癌旁组织细胞核中β-连环素表达水平，分析其与肿瘤组织浸润深度、淋巴结转移、组织分化程度、临床分期的关系。以无病生存时间（DFS）和总生存时间（OS）为评价指标，探讨β-连环素与胃癌患者预后的关系；ROC曲线衡量β-连环素在评估胃癌患者预后中的价值。结果：胃癌肿瘤组织细胞核内β-连环素的表达水平与年龄、性别无关（P＞0.05），与肿瘤的浸润深度、淋巴结的转移、TNM分期以及肿瘤的分化程度有关。Kaplan-Meier生存曲线显示：肿瘤组织细胞核内β-连环素阴性表达者DFS（26月）和OS（38月）优于阳性表达者DFS（18月）和OS（24月）（P＜0.05）；COX多因素分析：细胞核内β-连环素的表达可以作为胃癌患者OS独立预后因素（HR=0.87，95％CI：0.54~2.34，P=0.03）；ROC曲线显示，β-连环素在评估胃癌患者预后中具有中等价值（曲线下面积为0.82）。结论：胃癌组织细胞核内β-连环素表达水平与胃癌的TNM分期、淋巴结转移、浸润深度呈正相关性，与肿瘤的分化程度呈负相关性，可能是胃癌患者预后较差的标志物。

Objective To investigate the relations between β-catenin expression level in the nuclei and the clinical pathological factors of gastric cancer. Methods Immunohistochemical SP method was used to detectβ-catenin expression levels in gastric cancer tissue cell nucleus. The relationship betweenβ-catenin and tumor infiltration depth, lymph node metastasis, tissue differential degree, clinical stages was studied. Regarding disease-free survival （DFS） and overall survival （OS） as evaluation indexes to discuss β-catenin element＇s relationship with the prognosis of patients with gastric cancer. ROC curve was used to measure the value ofβ-catenin element in evaluation of the prognosis of patients with gastric cancer. Results β-catenin expression level in the nuclei of gastric cancer tumor tissue was not related to age, gender （P〉0.05）, but is associated with tumor infiltration depth （P〈0.01）, lymph node involvement （P〈0.05）, TNM staging （P〈0.05）, and the differentiation degree of tumor （P〈0.05）. Kaplan-Meier survival curves showed that DFS（26 months） and OS（38 months） in the patients of β-catenin negtive expression is better than DFS（18 months） and OS（24 months） in patients of positive expression. Cox Multiple factors analysis showed β-catenin expression in the nuclei can be used as an independent prognostic factor in patients with gastric cancer （HR = 0.87, 95% CI： 0.54~2.34, P =0.03）. ROC curve showed β-catenin had the same significance in evaluating the prognosis of patients with gastric cancer （area under the curve is 0.82）. Conclusion β-catenin expression level in the nuclei of gastric cancer was positively related to TNM staging, lymph node metastasis, and infiltration depth, but negatively to tumor differentiation degree. Its expression may be a marker of poor prognosis of patients with gastric cancer.