胃癌组织NPM表达及对胃癌患者预后的预测价值

Prognostic significance of nucleophosmin expression in gastric cancer

目的探讨胃癌组织中核磷蛋白(NPM)的表达与各临床病理因素的关系,评估其在胃癌侵袭转移过程中的作用及预测胃癌患者预后的价值。方法采用免疫组化法检测胃癌和癌旁组织中NPM的表达情况,并评估NPM表达与临床病理因素之间的关系。用Kaplan-Meier法及单因素和多因素分析来评估胃癌患者的术后生存率。结果胃癌组织中NPM阳性表达率为65.9%(54/82例),与癌旁组织中的阳性表达率(19.4%)比较差异有显著性(P<0.001);NPM阳性表达率与Lauren’s分型(P=0.025)、淋巴结转移(P=0.001)、浸润深度(P=0.010)、临床分期(P=0.033)及复发(P=0.006)等显著相关。胃癌患者的生存分析显示,NPM阴性组和阳性表达组生存率之间差异有显著性(P=0.021)。结论 NPM高表达与胃癌的浸润和转移密切相关,可以作为预测胃癌预后的一个生物学指标。

Objective To investigate the relationship between the expression of nucleophosmin （NPM） in gastric cancer tissue and clinicopathologic factors and prognosis, and evaluate the role of NPM in gastric cancer invasion and me- tastasis and the significance of predicting prognosis in gastric cancer patients. Methods We examined the NPM expres- sion of 82 gastric cancer and 36 gastrectomy mucosal tissue away from the cancer tissue more than 5cm by immunohisto- chemical method and evaluated the correlation between NPM expression and clinicopathological factors （age, sex, histol- ogy, tumor depth, lymph node status, clinical stages and recurrence）. We assessed the postoperative survival rates of gastric cancer by Kaplan-Meier method, univariate Cox regression analysis, and multivariate Cox regression analysis. Results NPM expression was detectable in 54 of the 82 tumors （65.9%） and in 7 of 36 gastrectomy mucosal tissue a- way from the cancer tissue more than 5cm （19.4%）. There was significant differences on their positive expression rates between in gastric cancer tissue and in normal gastric mucosa（P〈0. 001）. NPM positivity was significantly correlated with the Lauren＇s classification （P= 0. 025）, nodal involvement（P= 0. 001）, depth of invasion （P=0. 010）, clinical sta ges（P=0.033） and recurrence （P=0.006）. There were no significant differences between the positive expression rates of NPM and age, gender, tumor size and differentiated degree. Survival analysis of gastric cancer patients showed that the survival rate of NPM-negative group and NPM-positive group was significant differences （P=0. 021）. Conclusion These results sug- gest that NPM positive expression is strongly related to the invasion and metastasis of gastric cancer, and NPM can be used as a prognostic hiomarker of gastric cancer.