心房钠尿肽在胃癌中的表达及临床意义

Expression and Clinical Significance of Atrial Natriuretic Peptide in Gastric Cancer

目的:研究心房钠尿肽(ANP)在胃癌组织的表达情况,探讨其对胃癌发生发展的临床意义。方法:运用免疫组化检测40例术后切除胃癌组织和20例正常胃黏膜组织中ANP的表达情况,分析ANP在胃癌组织的表达与患者性别、年龄、分化程度、浸润深度、区域淋巴结转移、肿瘤分期、肿瘤分型这些临床病理特征的关系。结果:正常胃粘膜组织中ANP阳性表达率95%(19/20),强阳性表达,胃癌组织中ANP阳性表达率90%(54/60),弱表达,ANP在正常胃粘膜中的表达强于癌组织(P<0.05);胃癌组织中ANP的表达强度与肿瘤的分化程度呈正相关(P<0.01,r=0.383),与浸润深度呈负相关(P<0.01,r=-0.499),与淋巴结有无转移呈负相关(P<0.01,r=-0.396),与肿瘤分期呈负相关(P<0.01,r=-0.519),随着浸润程度的加深、淋巴结的转移、分期的不良ANP的表达强度逐渐减弱。此外,ANP的表达强度与患者性别、年龄、肿瘤分型无相关性(P>O.05);多因素分析发现,肿瘤的分化程度独立于这些临床病理特征影响着胃癌ANP的表达(P=0.013,95%CI=1.493~27.207,OR=6.256)。结论:ANP在正常胃粘膜的表达高于胃癌组织;ANP在胃癌组织中,肿瘤分化程度越好,表达越强;浸润程度愈深、肿瘤TNM分期越高,表达越弱;而且无区域淋巴结转移者较有转移者表达强;与性别、年龄、肿瘤分型无相关性,由此证明ANP与胃癌的发生发展相关,可作为潜在的抗胃癌的靶向药物。

Objective： To study the expression of atrial natriuretic peptide（ ANP） in gastric cancer and explore its clinical significance in the development and progression of gastric cancer. Methods： Immunohistochemistry was used to detect the expression of ANP in 40 cases of gastric cancer after resection and 20 cases of normal gastric mucosa. The relationship between the expression of ANP in gastric cancer tissue and the clinicopathological features of the patients＇ sex,age,degree of differentiation,depth of infiltration,regional lymph node metastasis,tumor stage and tumor typing were analyzed. Results： The positive expression rate of ANP in normal gastric mucosa was 95%（ 19/20）,which was strongly positive. The positive expression rate of ANP in gastric cancer tissues was 90%（ 54/60）,which was weakly expressed. The expression of ANP in normal gastric mucosa was stronger than that in cancer tissue（ P〈0.05）.The expression intensity of ANP in gastric carcinoma was positively correlated with the degree of tumor differentiation（ P〈0.01,r = 0.383）,which was negatively correlated with the depth of invasion（ P〈0.01,r =-0.499）,negatively correlated with lymph node metastasis（ P〈0.01,r =-0.396）,and negatively correlated with tumor stage（ P〈0.01,r =-0.519）. The expression intensity of ANP gradually weakened with infiltration depth,lymph node metastasis and stage failure.In addition,the expression intensity of ANP was not correlated with gender,age and tumor type（ P〉0.05）.Multiple factor analysis showed that the degree of differentiation of the tumor was independent of these clinicopathological features affecting the expression of ANP in gastric cancer（ P = 0.013,95%CI = 1.493 to 27.207,OR = 6. 256）. Conclusion： The expressions of ANP in normal tissues is higher than gastric carcinoma. The ANP expressions of gastic cacinoma is higher in better differentiation degree,but the expressions more decreased in deeper invasion,higher TNM stage and lymph node metastasized. There is no correlation among the groups in gender,age,and classification. So ANP correlates with the occurrence and development of gastric cancer gastric cancer,could be used as biological targeted drug.