Ezrin和HER2在胃癌组织芯片中的表达及意义

目的:探讨Ezrin蛋白在胃癌组织中的表达,与肿瘤浸润、转移的关系及与HER2的相互作用.方法:485例原发性胃癌组织中高、中、低分化胃癌分别为19例、235例和231例;有淋巴结转移者353例;TNM分期Ⅰ、Ⅱ期166例,Ⅲ、Ⅳ期319例.另外取距肿瘤7cm的正常胃黏膜组织40例.制成8个组织芯片蜡块,用免疫组织化学方法检测石蜡包埋的胃及胃癌组织中的Ezrin和人类表皮生长因子受体2(hum an epidermal growth factor receptor 2,HER2)蛋白表达.所有患者均经外科手术治疗,病理诊断明确,术前未经放、化疗.结果:Ezrin和HER2在胃癌组织中高表达,二者均与肿瘤Lauren’s分型和肿瘤分化程度相关(χ2=17.625,χ2=20.386,均P=0.000;χ2=9.474,P=0.009,χ2=13.377,P=0.010);Ezrin同时还与组织学(日本分型)、TNM分期、浸润深度和淋巴结转移相关(χ2=37.542,P=0.000;χ2=12.237,P=0.002;χ2=21.194,P=0.002;χ2=9.868,P=0.007).Ezrin和HER2蛋白表达呈正相关(r=0.129,P=0.004).结论:Ezrin可能是预测胃癌组织浸润、转移有用的指标;联合检测Ezrin和HER2可作为判断胃癌预后、筛选高危转移患者的有效指标并有可能用于指导胃癌的个体化治疗.

Clinical significance of expression of Ezrin and HER2 proteins in gastric cancer

AIM:To investigate the expression of Ezrin and human epidermal growth factor receptor 2(HER2) proteins in normal gastric mucosa and gastric cancer tissues and to analyze their correlation with tumor invasion and metastasis.METHODS:Immunohistochemistry was performed to detect Ezrin and HER2 protein expression using tissue microarray(TMA) containing paraffin-embedded normal gastric mucosa and gastric cancer tissue samples.Of 485 primary gastric adenocarcinoma samples detected,19 had well differentiated caner,235 had moderately differentiated cancer,and 231 had poorly differentiated cancer;353 had lymph node metastasis;166 had TNM stage I to II cancer,319 had stage III to IV cancer.Forty paraffin-embeddedtissue blocks of normal gastric epithelium were used as controls.RESULTS:Ezrin and HER2 protein expression in gastric cancer was signif icantly higher than in normal gastric mucosa.Ezrin and HER2 protein expression was closely associated with Lauren’ s histological type and tumor differentiation(χ2 = 17.625,20.386,both P = 0.000;χ2 = 9.474,P = 0.009,χ2 = 13.377,P = 0.010).Ezrin protein expression was also closely associated with Japanese histological type,TNM stage,depth of invasion and lymph node metastasis(χ2 = 37.542,12.237,21.194,9.868;P = 0.000,0.002,0.002,0.007).The expression of Ezrin was positively correlated to that of HER2 in gastric cancer(r = 0.129,P = 0.004).CONCLUSION:Ezrin protein may be a useful marker for predicting the invasion and metastasis of gastric cancer.Combined detection of expression of Ezrin and HER2 proteins can help predict prognosis and devise individualized treatment in patients with gastric cancer.