CD133、HER2及PODXL水平变化与胃癌病理特征、预后关系

The relationship between the changes of CD133,HER2 and PODXL levels and the pathological characteristics and prognosis of gastric cancer

目的研究CD133、人表皮生长因子受体2(HER2)及足糖萼蛋白(PODXL)表达与胃癌病理特征关系及其对预后生存的预测价值。方法收集80例胃癌患者的临床资料作为胃癌组,另选取同期本院健康体检者74例作为对照组,采用免疫组化方法检测两组受检者CD133、HER2及PODXL蛋白表达情况,并对CD133、HER2及PODXL蛋白表达与胃癌临床病理特征、预后生存进行统计分析。结果胃癌组CD133、HER2及PODXL阳性表达率高于对照组,差异有统计学意义(P<0.05)。CD133阳性、阴性表达者肿瘤直径、分化程度、TNM分期及淋巴结转移比较差异有统计学意义(P<0.05)。PODXL阳性表达者肿瘤分化程度、TNM分期均明显高于PODXL阴性表达者,差异有统计学意义(P<0.05)。术后对患者进行1年随访,其中死亡13例,死亡率为16.25%。多元Logistic回归分析结果显示,肿瘤分化程度低、TNM分期Ⅲ~Ⅳ、合并淋巴结转移、CD133、HER2及PODXL阳性表达是影响胃癌患者预后死亡的危险因素(P<0.05)。采用ROC曲线分析CD133、HER2及PODXL单项及联合检测对胃癌患者预后生存的预测价值,CD133、HER2及PODXL单项及联合检测曲线下面积分别为0.746、0.686、0.711、0.871。结论 CD133、HER2及PODXL在胃癌中存在异常表达,推测CD133、HER2及PODXL参与了胃癌组织增生、分化及发展过程,临床上可通过检测三者表达情况对患者病情进展及预后进行评估。

Objective To study the relationship between the expression of CD133,human epidermal growth factor receptor 2(HER2)and podoxalysin(PODXL)and the pathological characteristics of gastric cancer and its predictive value for prognostic survival.Method The clinical data of 80 patients with gastric cancer(gastric cancer group)were collected.In addition,74 patients who underwent physical examination in our hospital during the same period were selected as the control group.Immunohistochemical method was used to detect the expression of CD133,HER2,and PODXL protein in the two groups.And the CD133,HER2 and PODXL protein expression and the clinicopathological characteristics and prognostic survival of gastric cancer were analyzed.Result The positive expression rates of CD133,HER2 and PODXL in the gastric cancer group were higher than those in the control group,and the difference was statistically significant(P<0.05).There were statistically significant differences between patients with CD133 positive or negative expression in tumor diameter,degree of differentiation,TNM stage and lymph node metastasis(P<0.05).The degree of tumor differentiation and TNM stage in patients with positive expression of PODXL were significantly higher than those with negative expression of PODXL(P<0.05).The patients were followed up for 1 year after the operation,13 cases died,and the mortality rate was 16.25%.The results of multivariate logistic regression analysis showed that the low tumor differentiation,the TNM stageⅢ~Ⅳ,the combined lymph node metastasis,the positive expression of CD133,HER2 and PODXL were risk factors affecting the death prognosis of patients with gastric cancer(P<0.05).The ROC curve was used to analyze the predictive value of CD133,HER2 and PODXL alone and combined detection of them for the prognostic survival of patients with gastric cancer.The area under the curves of single CD133,HER2 and PODXL and the curve of combined detection were 0.746,0.686,0.711,0.871,respectively.Conclusion CD133,HER2 and PODXL are abnormally expressed in gastric cancer.It is speculated that CD133,HER2 and PODXL are involved in the proliferation,differentiation and development of gastric cancer tissue.Clinically,the progress and prognosis of patients can be evaluated by detecting the expression of these three.