NHE-1蛋白和V-ATPase在胃癌及癌前病变组织中的表达及临床意义

Expression of NHE-1 and V-ATPase in gastric cancer and precancerous lesions and their clinical significance

目的探讨Na+/H+交换蛋白-1(NHE-1)蛋白和空泡型质子ATP酶(V-ATPase)在胃癌和癌前病变组织中的表达及其临床意义。方法收集2014年1月至2019年12月在温州市中西医结合医院行胃镜检查时采取的胃黏膜组织标本及行胃癌手术采取的胃癌组织标本320例。采用免疫组化SP法检测NHE-1蛋白和V-ATPase的表达,分析NHE-1蛋白和V-ATPase在胃癌和癌前病变组织中的表达差异、与胃癌临床病理特征的关系、两者表达的相关性及对胃癌患者预后的影响。结果胃癌组织中NHE-1蛋白及V-ATPase的阳性表达率均高于癌前病变组织,差异均有统计学意义(均P<0.05)。胃癌组织中NHE-1蛋白及V-ATPase的表达与性别、年龄、肿瘤大小、分化程度均无关(均P>0.05),但与浸润深度、淋巴结转移、TNM分期均有关(均P<0.05)。Spearman等级相关分析显示胃癌组织中NHE-1蛋白表达和V-ATPase表达呈正相关(r=0.299,P<0.05)。NHE-1蛋白表达阴性组、弱阳性组和强阳性组胃癌中位生存时间比较差异有统计学意义(P<0.05),V-ATPase表达阴性组、弱阳性组和强阳性组胃癌中位生存时间比较差异有统计学意义(P<0.05),NHE-1蛋白和V-ATPase均表达组、NHE-1蛋白表达组、V-ATPase表达组和NHE-1蛋白和V-ATPase均不表达组胃癌中位生存时间比较差异有统计学意义(P<0.05)。结论胃黏膜组织中NHE-1蛋白和V-ATPase过表达可能导致胃癌的发生和发展。

Objective To explore the expression of Na^(+)/H^(+)exchanger 1(NHE-1)protein and vacuolar H^(+)-ATPase(V-ATPase)in gastric cancer and precancerous lesions and their clinical significance.Methods From January 2014 to December 2019,152 gastric cancer samples and 113 precancerous gastric mucosa samples were taken from gastroscopic biopsy or surgery in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine.Immunohistochemical SP method was used to detect the expression of NHE-1 and V-ATPase.The relationship of NHE-1 and V-ATPase expression with the clinicopathological characteristics and the prognosis of gastric cancer patients was analyzed.Results The positive expression rates of NHE-1 and V-ATPase in gastric cancer were significantly higher than those in precancerous lesions(all P<0.05).The expression of NHE-1 protein and V-ATPase in gastric cancer were not associated with gender,age,tumor size and differential degree(all P>0.05),but significantly associated with depth of invasion,lymph node metastasis and TNM stage(all P<0.05).Spearman rank correlation analysis showed that NHE-1 expression was positively correlated with V-ATPase expression in gastric cancer(r=0.299,P<0.05).There were significant differences in the median survival time among gastric cancer patients with negative,weak positive and strong positive NHE-1 expression(P<0.05),and among those with negative,weak positive and strong positive V-ATPase expression(P<0.05).There were significant differences in median survival time among gastric cancer patients with both NHE-1 and V-ATPase positive expression,with NHE-1 expression,with V-ATPase expression,with both NHE-1 and V-ATPase negative expression(P<0.05).Conclusion Overexpression of NHE-1 and V-ATPase is closely related to the occurrence and development of gastric cancer.