胃癌p21 ras表达与临床病理因素及X线形态学的研究

Study on the relationship between expression of p21ras, the X-Ray morphology and pathologic factors in gastric carcinoma

目的 研究 p2 1ras与胃癌临床病理因素及X线钡剂造影表现的关系和意义。方法 经低张气钡上消化道钡剂造影检查 ,确诊胃癌患者 35例 ,手术切除后新鲜标本沿大弯 (或小弯 )剖开 ,摄取大体标本照片 ,标本均匀涂钡 ,摄取标本涂钡照片 ;用免疫组化SP染色检测 35例胃癌手术标本中p2 1ras表达。结果 p2 1ras在胃癌组织中的阳性表达率明显高于癌旁及正常胃组织 (P <0 0 1) ,在胃癌分化程度、淋巴结转移方面无统计学意义。观察胃癌标本涂钡照片 2 9例 ,分析癌灶与周围正常粘膜皱襞中断情况 ,在高 中分化胃癌中 ,癌灶与周围正常粘膜皱襞中断截然的为 42 86 %;在低分化胃癌中 ,80 %的患者 ,癌灶与周围正常粘膜皱襞中断截然 ,但经统计学处理 P =0 0 6 ,无统计学意义 ;在胃癌的大体分型、淋巴结转移及浸润深度方面 ,与粘膜分界也无统计学意义。结论 胃癌大体形态学与 p2 1ras表达无显著相关性 ,粘膜中断形式在一定程度上可反映胃癌的生物学特性 ,是否可把 p2 1ras作为评判胃癌预后的一个确切指标 ,尚需进一步研究。

Objective: To investigate the correlation between p21ras,the X-ray morphology and pathologic factors in gastric carcinoma. Methods: Thirty-five cases of gastric cancer, which were found with lower tonic air-barium doublecontrast gastric examination, were operated,and the specimens were photographed by Olympus digital camera and then recorded with X-ray film after evenly coated with barium on the surface of membrane at HITACHI Tu-21 X-ray machine. The expression of p21ras was studied in 35 cases of gastric cancer by SP immunohistochemical technique. Results: There was a significant difference in p21ras expression between in the gastric cancer and in the paracancerous tissues and normal tissues (P<0.01).No significant correlation was found between grade of differentiation,lymph node metastasis and expression of p21ras. Twenty-nine cases were analysed to indicate the abruption of mucosal folds,there was complete division between the carcinoma and the normal tissues in poorly differentiated type,in well/moderately differentiated type;there was obscure division,but there was no statistical correlations. No significant correlation was found between abruption of mucosal folds, lymph node metastasis and grade of differentiation .Conclusion: No significant correlation is found between X-ray morphology and the abruption of mucosal folds,it is helpful for predicting biological characteristics of gastric carcinoma to examine the abruption of mucosal folds.Further examination is needed to confirm whether p21ras is a good index to indicate prognosis of gastric carcinoma.