p27~(Kip1)和细胞周期蛋白D1在胃癌中的表达及其预后意义

目的 :研究p2 7Kip1、细胞周期蛋白D1(cyclinD1)在胃癌组织中的表达水平以及与生物学行为的关系和对预后评价的意义。方法 :以免疫组化方法检测 92例胃癌组织中p2 7Kip1、cyclinD1蛋白的表达水平。结果 :本组 92例胃癌中 ,p2 7Kip1蛋白阳性 39例 ,占 42 .4% ;cyclinD1蛋白表达阳性 44例 ,占 47.8% ;胃癌组织中 ,p2 7Kip1蛋白水平与胃壁浸润深度、TNM分期、病理组织学分级、区域淋巴结转移均相关 (P <0 .0 5 ) ;cyclinD1蛋白表达与病理组织学分级负相关 (P <0 .0 5 ) ;p2 7Kip1与cyclinD1蛋白阳性表达显著相关 (P <0 .0 5 ) ;单变量生存分析结果 ,p2 7Kip1高表达组三年、五年生存率分别为 77.1%、5 7.8% ,明显高于低表达组的 33.7%、2 6 .3 % (P =0 .0 0 7) ,多变量分析显示p2 7Kip1是一个独立的预后指标 (P =0 .0 0 0 3)。结论 :p2 7Kip1可作为反映肿瘤恶性表型的指标 ,对胃癌预后具有一定的价值 ;cyclinD1是胃癌发生、发展过程中早期的分子事件 ;p2 7Kip1在胃癌进展中起着比cyclinD1更重要的作用。

Expression of p27~(Kip1) and cyclin D1 in human gastric carcinoma and its prognostic significance

Purpose:This study was designed to investigate the expression of p27 Kip1 and cyclin D1 in gastric carcinoma in relation to biological behavior and prognosis. Methods:p27 Kip1 and cyclin D1 expression at protein level were determined by immunohistochemistry technique in 92 patients with gastric carcinoma. Results:Of the 92 patients, p27 Kip1 expression was low in 28(71.8%) and high in 11(12%),respectively. Cyclin D1 expression was low in 32 (72.7%) and high in 12 (13%) ,respectively.p27 Kip1 expression level was correlated with histological grade, depth of invasion, lymph-node metastasis, TNM stage( P <0.05)as well as cyclin D1 expression level. Cyclin D1 expression level was inversely correlated with histological grade. Univariate analysis demonstrated better survival in the patients with higher p27 Kip1 expression than in those with lower expression. By Cox multivariate analysis, p27 Kip1 expression level was found to be of independent prognostic significance. Cyclin D1 expression was not correlated with survival of the patients.Conclusions:p27 Kip1 may be a useful marker for reflecting tumoral malignant behavior and estimating prognosis of human gastric cancer. Overexpression of cyclin D1 is a molecular event that may occur in the early stage. p27 Kip1 may play a more important role than cyclin D1 during the progression of gastric carcinoma.