瘦素蛋白在胃癌中的表达及其临床意义

Expression of leptin protein in gastric cancer and its clinical significance

目的探讨胃癌组织中瘦素蛋白的表达及其与患者临床病理特征和预后的关系。方法收集2009年1月至2012年12月陕西省肿瘤医院确诊的112例胃癌患者的癌组织标本,采用随机数字表法取材50例癌旁正常黏膜组织作为对照。应用免疫组织化学法检测瘦素蛋白的表达,并分析其表达与患者临床病理特征及预后的关系。结果瘦素蛋白阳性率在胃癌组织中为68.8%(77/112),在癌旁正常胃黏膜组织中为34.0%(17/50),差异有统计学意义(χ2=17.139,P<0.01)。瘦素蛋白表达与肿瘤脉管侵犯、浸润深度及TNM分期有关(均P<0.05)。瘦素蛋白表达与肿瘤浸润深度及TNM分期呈正相关(r=0.265,P=0.005;r=0.318,P=0.001)。瘦素蛋白表达阳性与阴性患者的5年总生存率分别为65.2%和78.4%,差异有统计学意义(χ2=9.526,P=0.002);术前行新辅助化疗与未行新辅助化疗患者的5年总生存率分别为71.7%和67.6%,差异无统计学意义(χ2=2.321,P=0.128)。在瘦素蛋白阳性表达患者中,行新辅助化疗与未行新辅助化疗患者的5年总生存率分别为47.4%和74.2%(χ2=6.336,P=0.012);在瘦素蛋白阴性表达患者中,行新辅助化疗与未行新辅助化疗患者的5年总生存率分别为92.3%和18.2%(χ2=14.237,P<0.01)。Cox多因素回归分析显示,瘦素蛋白表达状态、淋巴结转移、病理分级、脉管侵犯、TNM分期是胃癌患者预后的独立影响因素(均P<0.05)。结论瘦素蛋白在胃癌组织中高表达,可作为判断胃癌患者预后及化疗效果的标志物。

Objective To investigate the relationship between the expression of leptin protein and clinicopathological features and prognosis of gastric cancer. Methods The cancer tissue specimens of 112 patients diagnosed with gastric cancer in Shaanxi Provincial Cancer Hospital from January 2009 to December 2012 were collected. Random number table method was used to select 50 cases of paracancerous normal mucosa tissues as the controls. The expression of leptin protein was detected by using immunohistochemistry. And the relationship between the expression of lepin protein and the clinicopathological features and prognosis was analyzed. Results The positive rate of leptin protein in gastric cancer tissues was higher than that in paracancerous normal gastric mucosa tissues, and the difference was statistically significant [68.8%(77/112) vs. 34.0%(17/50),χ2 = 17.139, P < 0.01]. The expression of leptin protein was associated with tumor vessel invasion, invasion depth and TNM stage (all P < 0.05). The expression of leptin protein was positively correlated with tumor invasion depth and TNM stage (r = 0.265, P = 0.005;r = 0.318, P = 0.001). The 5-year total survival rates of patients with positive and negative expression of leptin protein were 65.2% and 78.4%, respectively, and the difference was statistically significant (χ 2 = 9.526, P = 0.002). The 5-year total survival rates of patients who received neoadjuvant chemotherapy or not were 71.7% and 67.6%, respectively, and the difference was not statistically significant (χ 2 = 2.321, P = 0.128). In patients with positive expression of leptin protein, 5-year total survival rates of patients who received neoadjuvant chemotherapy or not were 47.4% and 74.2%, respectively (χ 2 = 6.336, P = 0.012). In patients with negative expression of leptin protein, 5-year total survival rates of patients who received neoadjuvant chemotherapy or not were 92.3% and 18.2%, respectively (χ 2 = 14.237, P < 0.01). Cox multivariate regression analysis showed that leptin protein expression, lymph node metastasis, pathological grading, vessel invasion and TNM stage were independent prognostic factors for patients with gastric cancer (all P < 0.05). Conclusion Leptin protein is highly expressed in gastric cancer tissues, and it can be used as a marker for judging the prognosis and chemotherapy effect of gastric cancer patients.