IRS-2蛋白在胃癌组织中的表达及其对术后预后的预测价值

The expression of IRS-2 protein in gastric cancer tissues and its predictive value for postoperative prognosis

[目的]研究胰岛素受体底物-2(IRS-2)蛋白在胃癌组织中的表达及其对术后预后的预测价值。[方法]收集确诊为胃癌并且进行了胃癌根治术、D2淋巴结清扫术和术后辅助化疗的患者110例,对患者的病理资料进行整理并且收集患者的胃癌组织石蜡切片。应用免疫组织化学(IHC)SP法检测IRS-2蛋白表达。分析IRS-2蛋白在胃癌组织中的阳性表达,应用COX比例模型进行生存分析。[结果]IRS-2高表达时组织免疫组化染色为棕黄色,主要分布位置为细胞质。IRS-2在胃癌组织、癌旁组织中的阳性表达率分别为56.36%、18.18%,胃癌组织中的IRS-2表达要高于癌旁组织(P<0.05)。其中IRS-2高表达患者的中位无瘤生存时间为19.3个月,低于IRS-2低表达组患者的23.7个月(log-Rank P=0.013),IRS-2高表达患者的总生存时间为22.6个月,明显低于IRS-2低表达组的31.0个月(log-Rank P=0.024);经过Cox模型进行单因素分析发现,IRS-2、病理学N分期、脉管癌栓、肿瘤分化程度和肿瘤发病部位与患者的无瘤生存时间有着密切的关系。将单因素分析存在意义变量纳入多因素分析模型,结果显示IRS-2、病理学N分期、脉管癌栓和肿瘤分化程度是胃癌患者总生存时间的独立预后因素(P<0.05)。[结论]胃癌患者肿瘤组织中IRS-2蛋白表达水平较高,IRS-2高表达是胃癌根治术并且接受术后化疗患者预后的独立影响因素。

[Objective]To study the expression of insulin receptor substrate-2(IRS-2)protein in gastric cancer tissues and its predictive value for postoperative prognosis.[Methods]A total of 110 patients diagnosed with gastric cancer who underwent radical gastrectomy,D2 lymph node dissection and postoperative adjuvant chemotherapy were collected.The pathological data of the patients were collected.The paeaffin section of the patient's gastric cancer tissue were collcted.Immunohistochemistry(IHC)SP method was used to detect the expression of IRS-2 protein.The positive expression of IRS-2 protein in gastric cancer tissues was analyzed,and the COX scale model was used for survival analysis.[Results]Tissue immunohistochemical staining was brown-yellow when IRS-2 was highly expressed,and its main location was in cytoplasm.The positive expression rate of IRS-2 in gastric cancer tissue was 62/110(56.36%),and the positive expression rate in adjacent tissues was 20/110(18.18%).The expression of IRS-2 in gastric cancer tissue was higher than Adjacent tissues(P<0.05).Among them,the median tumor-free survival time of patients with high IRS-2 expression was 19.3 months,which was lower than the 23.7(log-Rank P=0.013)of patients with IRS-2 low expression group,and the overall survival rate of patients with high IRS-2 expression was 22.63 month,significantly lower than the IRS-2 low expression group(31.0 month,log-Rank P=0.024);univariate analysis of Cox model found that IRS-2,pathological N staging,vascular tumor thrombus,tumor differentiation degree and tumor incidence were closely related.There was relationship between the location and the patient's tumor-free survival time.The single-factor analysis of significance variables was incorporated into the multivariate analysis model.The results showed that IRS-2,pathological N staging,vascular tumor thrombus,and tumor differentiation the same as those of gastric cancer patients were the independent prognostic factors of tumor survival time and the overall survial time(P<0.05).[Conclusion]The expression level of IRS-2 protein in the tumor tissues of patients with gastric cancer is relatively high.The high expression of IRS-2 is an independent factor influencing the prognosis of patients undergoing radical gastric cancer surgery and receiving postoperative chemotherapy.