贲门胃底癌神经旁浸润与CIP2A表达及其预后意义

Correlation of perineural invasion with CIP2A expression and prognosis in patients with cardia-fundal carcinoma

目的检测神经旁浸润(perineural invasion,PNI)在人贲门胃底癌中的发生情况,探讨其与磷酸酶2A的癌性抑制因子(cancerous inhibitor of protein phosphatase 2A,CIP2A)的相关性以及二者对贲门胃底癌预后的影响。方法检测85例贲门胃底癌组织中PNI的发生及CIP2A的表达,分析PNI与CIP2A表达和贲门胃底癌临床病理特征的关系及其在贲门胃底癌患者预后中的价值。结果 PNI阳性者30例(35.3%),PNI的发生与T分期、癌栓、N分期、TNM分期及CIP2A表达均相关。单因素生存分析显示,贲门胃底癌患者的总生存率与T分期、癌栓、N分期、TNM临床分期、PNI和CIP2A有关(P均<0.01);PNI阳性组的平均生存期为14.3个月,低于阴性组的48.5个月(P<0.01)。CIP2A阳性组的平均生存期为22.7个月,低于阴性组的45.6个月(P<0.01)。多因素分析显示PNI和CIP2A阳性表达是影响患者总生存率的独立危险因素(P均<0.01)。结论PNI与贲门胃底癌的进展有关,贲门胃底癌术后检测PNI和CIP2A可以提示患者预后,CIP2A可能在PNI的发生过程中发挥一定的协同作用。

Purpose To investigate the presence of perineural invasion （PNI） and the correlation with cancerous inhibitor of protein phosphatase 2A （CIP2A） and determine their prognostic significance in patients with cardia-fundal carcinoma. Methods Paraffin sections of surgical specimens from 85 patients who underwent gastric resection were selected, and then PNI and CIP2A expression was detected. The correlation of perineural invasion with the clinicopathological features and CIP2A expression were performed. Survival analysis was done in all patients. Results PNI was positive in 30 of 85 patients （35.3 % ）. The occurrence of PNI was significantly as- sociated with T stage, tumor thrombi, N stage, TNM stage and expression of CIP2A. The overall survival of the PNI-positive or CIP2A- positive patients was much worse than that of the PNI-negative or CIP2A-negtive patients by univariate analysis （ P 〈 0. 01 ）, which were also influenced by T stage, tumor thrombi, N stage and TNM stage （P 〈 0. 01 ）. By muhivariable Cox proportional hazards model of overall survival, the positivity of PNI and CIP2A appeared to be new independent prognostic factors （P 〈 0. 01 ）. Conclusion PNI is associated with the advancement of cardia-fundal cancer. PNI and CIP2A will be candidates of new prognostic factors. In addition, CIP2A may be responsible for the presence of perineural invasion.