胃癌患者Bmi-1、CDH17、胃蛋白酶原检测及与临床病理特征的关系

Detection of Bmi-1,CDH17 and pepsinogen in patients with gastric cancer and its relationship with clinicopathological characteristics

目的:探究胃癌患者黏膜组织细胞特异性莫洛鼠白血病病毒插入位点1(Bmi-1)、肝肠钙黏连蛋白17(CDH17)及胃蛋白酶原(PGC)表达,并分析这3项指标与患者临床病理特征的关系。方法:随机选取2016年12月—2019年12月确诊并行手术的胃癌患者80例,另选择同期30例胃良性病变患者作为对照组。取手术标本切片,进行免疫组织化学法测定胃黏膜组织Bmi-1、CDH17、PGC及肿瘤标志物[血清糖类抗原50(CA50)、CA199、CA242、CA724及癌胚抗原(CEA)]表达,并采用酶联免疫吸附法(ELISA)检测所有患者血清肿瘤标志物水平,根据胃癌TNM分期分为Ⅰ~Ⅳ期,对比不同分期各指标差异,并分析Bmi-1、CDH17及PGC与临床病理特征的相关性。结果:胃癌患者Bmi-1、CDH17及PGC表达阳性水平均显著高于胃良性病变患者(P<0.05);随着胃癌患者TNM分期升高,Bmi-1、CDH17及PGC表达阳性率进一步升高,胃癌Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期患者Bmi-1、CDH17及PGC阳性率比较差异有统计学意义(P<0.05)。胃癌患者血清及胃黏膜组织中CA50、CA199、CA242、CA724及CEA水平显著高于胃良性病变患者,且随着胃癌患者TNM分期升高,血清CA50、CA199、CA242、CA724及CEA水平进一步升高,各组比较差异有统计学意义(P<0.05)。Spearman等级相关分析结果显示,胃癌组织中Bmi-1、CDH17、PGC、CA50、CA199、CA242、CA724及CEA表达存在呈正相关性(P<0.05)。胃癌患者不同性别、不同年龄、是否远处转移Bmi-1、CDH17、PGC阳性率比较,差异无统计学意义(P>0.05);不同肿瘤分化程度、不同TNM分期、是否淋巴转移、不同肿瘤大小、不同浸润深度Bmi-1、CDH17、PGC阳性率比较,差异有统计学意义(P<0.05)。结论:在胃癌的发生发展过程中,Bmi-1、CDH17、PGC表达明显提高,并与胃癌患者的临床病理特征存在相关性,检测Bmi-1、CDH17、PGC表达对于反映胃癌生物学行为具有重要意义。

Objective: To investigate the expression of murine mucosa cell specific murine leukemia virus insertion site 1(Bmi-1), hepatoenteric cadherin 17(CDH17) and pepsinogen(PGC) in gastric cancer patients and its relationship with clinicopathological characteristics. Methods: We randomly selected of 80 patients with gastric cancer diagnosed and operated in our hospital from December 2016 to December 2019, and selected 30 patients with benign gastric lesions as the control group during the same period.Surgical specimens was taken and immunohistochemistry was performed to determine gastric mucosa tissue Bmi-1, CDH17, PGC and tumor markers(serum carbohydrate antigen 50[CA50], CA199, CA242, CA724 and carcinoembryonic antigen[CEA])expression, and enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of serum tumor markers of all patients. According to the TNM stage of gastric cancer, all patients were divided into stages Ⅰ to Ⅳ, the differences of different indexes in different stages were compared, and the correlation between Bmi-1, CDH17 and PGC and clinicopathological characteristics was analyzed. Results: The positive expression levels of Bmi-1, CDH17 and PGC in patients with gastric cancer were significantly higher than those with benign gastric lesions(P<0.05). With the increase of TNM stage in gastric cancer patients, the positive rates of Bmi-1, CDH17 and PGC expression increased further. The positive rates of Bmi-1, CDH17 and PGC in patients with gastric cancer stage I, stage II, stage III and stage IV were statistically significant(P<0.05). The levels of CA50, CA199, CA242, CA724 and CEA in serum and gastric mucosa tissue of patients with gastric cancer were significantly higher than those with benign gastric lesions, and as the TNM stage of gastric cancer patients increased, the levels of serum CA50, CA199, CA242, CA724 and CEA further increased. The difference between the groups was statistically significant(P<0.05). Spearman rank correlation analysis showed that there was a positive correlation between the expression of Bmi-1, CDH17, PGC, CA50, CA199, CA242, CA724 and CEA in gastric cancer tissues(P<0.05). There was no statistically significant difference in the positive rates of Bmi-1, CDH17 and PGC between different genders, different ages, and distant metastasis in patients with gastric cancer(P>0.05). The difference in the positive rates of Bmi-1, CDH17 and PGC at different infiltration depths was statistically significant(P<0.05). Conclusion: During the development of gastric cancer, the expressions of Bmi-1, CDH17 and PGC were significantly increased, and there was a correlation with the clinicopathological characteristics of patients with gastric cancer. The detection of Bmi-1, CDH17 and PGC expression may be of great significance to reflect the biological behavior of gastric cancer.