一氧化氮合酶和微血管生成与胃癌发展的关系

Relation of inducible nitric oxide synthase and angiogenesis to the progression of gastric carcinoma

目的 研究诱导型一氧化氮合酶 (iNOS)在人胃癌组织中的表达及其与胃癌微血管形成、淋巴结转移及临床分期的关系。方法 采用免疫组化S P法检测 50例原发性胃癌组织、癌周组织及 2 0例正常胃黏膜组织中iNOS的表达 ,同时检测微血管密度 (MVD) ,以抗CD3 4标记血管内皮细胞 ,并分析其与肿瘤行为之间的关系。结果 50例胃癌组织中iNOS阳性表达率为 70 .0 % ,MVD均值为 2 2 .0± 9 .8,显著高于癌周组织 (16.2 % ,6.1± 3 .4)和正常胃组织 (15.0 % ,5.5± 2 .6;P <0 .0 1)。按TNM分期 ,Ⅳ期胃癌组织iNOS阳性表达率为 93 .8% ,MVD为 42 .3± 3 .7,两者显著高于Ⅰ、Ⅱ、Ⅲ期 ,差异有显著性 (P <0 .0 1)。有淋巴结转移组iNOS的阳性表达率为 84.6% ,MVD均值为 2 7.4± 6.5;无淋巴结转移组iNOS阳性表达率为 54.2 % ,MVD均值为 15.3± 4.7,两组差异有显著性 (P <0 .0 5)。iNOS阳性表达组及高MVD值 (≥ 2 2 .0 )组的 3年生存率均显著低于iNOS阴性表达组及低MVD值 (<2 2 .0 )组 ,差异有显著性 (P <0 .0 5)。结论 胃癌组织中iNOS高阳性表达 ,随着iNOS阳性表达的增强 ,MVD值也增加 ,两者呈正相关。iNOS的表达及MVD与胃癌TNM分期、淋巴结转移及预后有密切关系。

Objective To investigate the expression of inducible nitric oxide synthase (iNOS) in human gastric carcinoma and its relationship with angiogenesis, lymph nodes metastasi s and clinical staging of gastric carcinoma. Methods The expression of iNOS in 50 patients with gastric carcinoma was studied with im munohistochemical method. Microvessel density (MVD) of human gastric carcinoma was also determined with anti-CD34 as the labelled vascular endothelial cells. Results The rate of expression of iNOS in 50 cases of gastric carcinoma was 70.0% , and MVD averaged 22.0±9.8, higher than those in the tissues around cancer (16 .2%,6.1±3.4) and normal gastric tissues (15.0%,5.5±2.6; P <0.01). Judged by the standard TNM criteria, the rate of expression of iNOS in stage Ⅳ(93.8%) was higher than that in stageⅠ,Ⅱ and Ⅲ( P <0.05), respectively. MV Ds in stage Ⅲ and Ⅳ were higher than those in stage Ⅰand Ⅱ ( P <0.05), respecti v ely. The expression of iNOS in gastric carcinoma specimens with lymph node metas tasis was 84.6%, and MVD averaged 27.4±6.5, higher than those in the specimens with absence of metastasis. In addition, the 3-year survival rate of patients w ith positive iNOS or high MVD was significantly less than that of patients with negative iNOS or low MVD ( P <0.05). Conclusions The expression rate of iNOS in human gastric carcinoma is high, and it has close relations to carcinoma angiogenesis, TNM staging and the lymph node metastasis, and thus it can be used to predict the prognosis of gastric carcinoma.