胃癌活检标本癌转移相关基因表达与淋巴结转移的预测

目的：检测活检标本中10项癌转移相关基因的表达与淋巴结转移的关系，探讨它们在预测胃癌淋巴结转移中的应用价值。方法：采用免疫组化S-P法，检测44例胃镜活检胃癌粘膜CD44V6、E-cadherin、VEGF、EGFR、p53、nm23-H1、Fas、FasL、Cath-B、Cath-D的表达情况，分析其与胃癌淋巴结转移的相关性。结果：VEGF和EGFR与胃癌淋巴结转移呈正相关，Fas与胃癌淋巴结转移呈负相关。VEGF( )EGFR( )、VEGF( )E-cadherin(-)、VEGF( )Fas(-)及EGFR( )Fas(-)等4对两两组合显示与胃癌淋巴结转移有关。3个因素预测胃癌淋巴结转移的敏感性和特异性偏低，4对两两组合可提高预测胃癌淋巴结转移的特异性，但敏感性明显降低。结论：检测活检标本癌转移相关基因的表达在预测胃癌淋巴结转移的临床实际应用意义不大。

Prediction of lymph node metastasis and the expression of cancer associated genes in endoscopic biopsy specimens of stomach cancer

Purpose:To study the correlation between lymph node metastasis(LNM) and the expression of 10 cancer associated genes in endoscopic biopsy specimens of stomach cancer and to investigate their value in predicting metastasis.Methods:The expression of CD44V6,E cadherin, VEGF, EGFR, P53, nm23 H1, Fas, FasL, Cath B, Cath D was detected by immunohistochemistry in 44 endoscopic biopsy specimens and correlated to the incidence of LNM. Results:The LNM of stomach cancer was positively correlated with the level of expression of VEGF and EGFR, but negatively correlated with that of Fas expression. Co expressions of VEGF(+)EGFR(+), VEGF(+)E cadherin( ), VEGF(+)Fas( ) and EGFR(+)Fas( ) were related with the LNM respectively. The sensitivity and specificity for predicting LNM were low when 3 single index was observed. The specificity for predicting LNM was increased, but the sensitivity was very much decreased when 4 co indexes were observed. Conclusions:The examination of cancer associated genes in endoscopic biopsy specimens of stomach cancer is of no clinical significance in predicting LNM of stomach cancer.