CNTF在胃癌组织中的表达及意义

Significance and expression of CNTF in gastric cancer

目的检测睫状神经营养因子(ciliary neurotrophic factor,CNTF)在胃炎-上皮内瘤变-胃癌的病理改变过程中的表达,以及表达量与胃癌临床病理特征和预后的关系。方法收集2011年8月至2012年11期间西安交通大学第一附属医院进行手术的胃癌患者肿瘤组织140例、癌旁组织140例,以及行胃镜检查并行内镜下活检的慢性胃炎30例及上皮内瘤变组织14例。免疫组化法检测CNTF的表达,结果采用组化评分表示。统计分析CNTF表达量在不同病变胃黏膜中的变化以及与胃癌临床病理特征的关系,并分析CNTF表达对胃癌患者预后的影响。结果CNTF组化评分在胃癌组织中高于上皮内瘤变组织及相应癌旁组织(P<0.05)。CNTF评分在上皮内瘤变组织及慢性胃炎组间,慢性非萎缩性胃炎和萎缩性胃炎组间差异无统计学意义(P>0.05)。胃癌中CNTF的表达与胃癌病人年龄、性别未见明显统计学关联;与病理分级、浸润深度、淋巴结转移、远处转移、TNM分期相关(P<0.05)。生存分析显示CNTF阳性及阴性组间生存率存在统计学意义(P<0.05)。多因素分析显示,CNTF表达是胃癌患者预后不良的独立危险因素(HR=0.568,95%CI=0.372-0.867,P<0.05)。结论CNTF在胃癌组织中高表达,并与胃癌预后相关,提示CNTF在胃癌发生发展中可能存在促进作用。

Objective To detect the expression of ciliary neurotrophic factor(CNTF)in the progress of stomach carcinogenesis(chronic gastritis-gastric epithelial neoplasia-gastric carcinoma)and analyze the correlation between CNTF expression and clinical pathological characteristics,prognosis.Methods From August 2011 to October 2012 in the First Affiliated Hospital of Xi’an Jiaotong University,30 cases of chronic gastritis,14 cases of gastric epithelial neoplasia,140 cases of gastric cancer and 140 cases of precancerous tissues were collected during operation or endoscopy examinations.In different gastric lesion tissues,the expression of CNTF was detected by immunohistochemistry and presented with immunohistochemical score.Correlations between CNTF expression and clinical pathological characteristics,prognosis were also analyzed.Results CNTF histochemistry score in gastric cancer tissues was significantly higher than that in gastric epithelial neoplasia and the corresponding precancerous tissues(P<0.05).No significant difference of CNTF expression was observed between gastric epithelial neoplasia group and chronic gastritis group(P>0.05),and between chronic non-atrophy gastritis group and chronic atrophy gastritis group(P>0.05).CNTF expression was significantly correlated with pathological grading,infiltrative depth,lymph node metastasis,distant metastasis and TNM staging(P<0.05),but not with age and gender.CNTF expression was associated with overall survival(P<0.05).Multi-factor analysis showed that CNTF expression was an independent risk prognostic factor of gastric cancer(HR=0.568,95%CI=0.372-0.867,P<0.05).Conclusion CNTF expression is higher in gastric cancer and correlated with prognosis,indicating that CNTF may promote the generation and progression of gastric cancer.