睾丸肿瘤DNA倍体及HLA—I抗原检测的预后意义

运用流式细胞仪和免疫经技术对５５例睾丸肿瘤ＤＮＡ倍体和ＨＬＡ－Ｉ抗原表达进行分析。３例二倍体肿瘤均存尖，异倍体肿瘤中非三倍体肿瘤３４例，死亡７例，平均存活时间４１．２个月，三倍体肿瘤１６例，死亡１０例，平均存活时间１５．５个月，ＨＬＡ－Ｉ抗原阳性者２７例，死亡４例，平均存活４０．０个月，阴怀者２５例，死亡１３例，平均存活１２．７个月，综合二者进行评估时，ＨＬＡ－Ｉ抗原阴怀的三倍体肿瘤预后最差。     

睾丸肿瘤组织HLA－I抗原表达与预后的关系

为探讨睾丸肿瘤组织ＨＬＡ－Ｉ抗原表达与预后的关系，采用免疫组织化学方法（ＡＢＣ法）对５５例睾丸肿瘤组织的石蜡切片进行检测，以观察其ＨＬＡ－Ｉ抗原的表达情况。结果：正常睾丸组织、间质组织Ｌｅｙｄｉｇ细胞呈深棕黄染色（卅），在曲细精管内Ｓｅｒｔｏｌｉ细胞染色（）。５５例睾丸肿瘤组织中，精原细胞瘤Ⅰ期的７２．０％，Ⅲ期的５４．６％染色；非精原细胞瘤仅Ⅰ期的７５．０％染色，ＨＬＡ－Ｉ抗原的表达随肿瘤临床分期增加而减弱或消失；ＨＬＡ－Ｉ抗原表达阳性的睾丸肿瘤的预后比表达阴性者好（Ｐ＜０．０５）。表明某些睾丸肿瘤ＨＬＡ－Ｉ抗原表达的减少与组织学类型、临床分期和肿瘤病理学特点有关。提示这些睾丸肿瘤能逃逸宿主的免疫监视，增加肿瘤的侵袭性；睾丸肿瘤组织中ＨＬＡ－Ｉ抗原表达可作为患者预后及监视治疗方案的有用指标。     

HLA表现型与骨肉瘤相关性研究

作者为探索中国汉人骨肉瘤与ＨＬＡ表型的相关性，采用补体依赖微量淋巴细胞毒技术，检测了３４例骨肉瘤患者及２５０例健康人的ＨＬＡ－Ａ、Ｂ、ＤＲ、ＤＱ座位上各ＨＬＡ表型，并统计分析了这些表型与骨肉瘤疾病、患者的预后和病理特征的相关意义。结果：ＨＬＡ－Ｂ３５表型在骨肉瘤组的频率为０．４１，对照组为０．０４８，含ＨＬＡ－Ｂ３５抗原的中国汉人发生骨肉瘤的相对危险性是无此抗原者的１３．５０倍（Ｐ值＜０．００１）。ＨＬＡ－Ｂ１３表型在预后不良患者中的频率为０．６７，良好患者中为０．０６，含ＨＬＡ－Ｂ１３抗原的骨肉瘤患者预后不良的相对危险性是无此抗原者的２０．４３倍（Ｐ值＜０．０１）。ＨＬＡ－Ｂ４０表型在预后不良患者中的频率是０．２２，良好患者中为０．７０，含ＨＬＡ－Ｂ４０抗原的患者预后良好的相对安全率是无此抗原者的６．８２倍（Ｐ值＜０．０５）。未发现ＨＬＡ表型与骨肉瘤病理特征间有相关性意义。结论：ＨＬＡ－Ｂ３５与中国汉人骨肉瘤的易感性基因紧密连锁，ＨＬＡ－Ｂ１３和ＨＬＡ－Ｂ４０则分别与骨肉瘤恶性基因和抵抗基因有关。ＨＬＡ－Ａ、ＤＲ、ＤＱ座位上无抗原表型与骨肉瘤有关，亦无ＨＬＡ表型与骨肉瘤病理特征相关。     

肾移植受者血清可溶性HLA-I类抗原的动态监测

目的　了解血清可溶性ＨＬＡＩ类抗原（ｓＨＬＡＩ） 与肾移植受者发生急性排斥反应及感染的关系。　方法　应用酶联免疫法动态监测３６ 例肾移植受者ｓＨＬＡＩ水平。　结果　尿毒症组ｓＨＬＡＩ水平为（２－９４±０－３４）μｇ／Ｌ,显著高于正常对照组（０－７６±０－３３）μｇ／Ｌ（Ｐ＜ ０－０５） 。移植后功能稳定组ｓＨＬＡ降至（０－６３±０－３１ ）μｇ／Ｌ,显著低于尿毒症组（ Ｐ＜０－０５）。ｓＨＬＡＩ在发生排斥反应前３ 天及感染后５～７ 天显著升高。　结论　ｓＨＬＡＩ可作为监测肾移植受者急性排斥反应和感染的参数。     

睾丸肿瘤组织HLA—I抗原表达与预后的关系

为探讨睾丸肿瘤组织ＨＬＡ－Ｉ抗原表达与预后的关系，采用免疫组织化学方法（ＡＢＣ法）对５５例睾丸肿瘤组织的石蜡切片进行检测，以观察其ＨＬＡ－Ｉ抗原的表达情况。结果：正常睾丸组织、间质组织Ｌｅｙｄｉｇ细胞呈深棕黄染色，在曲细精管内Ｓｅｒｔｏｌｉ细胞染色（＋＋）。５５例睾丸肿瘤组织中，精原细胞瘤Ｉ期的７２．０％，Ⅱ期的５４．６％染色；非精原细胞瘤仅Ⅰ期折７５．０％染色，ＨＬＡ－Ｉ抗原的表达随肿瘤临床分期     

激素敏感型肾病综合征小儿的HLA

为了解中国汉族儿童激素敏感型肾病综合征与ＨＬＡ的关系，研究了３７名该病患儿的ＨＬＡ－Ａ，Ｂ，ＤＲ，ＤＱ抗原频率，ＨＬＡ－Ａ，Ｂ抗原与本病无关联，ＨＬＡ－ＤＲ７抗原频率（３７．８４％）较对照组（１１．２３％）有显著性增高（Ｐｃ＝１．７×１０－３），ＨＬＡ一ＤＱ抗原较对照组低（３２．４３％与６１．４０％，Ｐｃ＝７．７×１０－３），频复发或频反复病人与ＨＬＡ－ＤＲ９抗原相关（Ｐｃ＝２．９×ｌ０－２）。支持该病有免疫遗传基础的假说     

食管癌组织中P16蛋白表达及其临床意义

目的探讨Ｐ１６蛋白表达在食管癌中的临床意义。方法应用免疫组织化学Ｓ－Ｐ法研究了６１例食管癌组织标本中Ｐ１６蛋白表达与食管癌临床病理特征及预后的关系，以及与增殖细胞核抗原（ＰＣＮＡ）的关系。结果Ｐ１６蛋白阳性表达率为４４．３％，其表达与浸润程度、有无淋巴结转移在统计学上无差异（Ｐ＞０．０５），与分化程度、ＴＮＭ分期有关（Ｐ＜０．０５），与ＰＣＮＡ之间存在相关（Ｐ＜０．０１），与术后肿瘤有无转移、复发在统计学上有差异（Ｐ＜０．０５），Ｐ１６阳性表达组的术后生存时间明显高于阴性组（Ｐ＜０．０１）。结论食管癌组织中Ｐ１６蛋白表达对细胞增殖起负性调控作用，检测其表达有助于对食管癌患者预后的判断。     

肾细胞癌bc1－2、P53、ER、PR的表达及临床意义

为了更好地选择估价肾细胞癌预后的指标，应用免疫组化技术检测５４例肾细胞癌中ｂｃ１－２、Ｐ５３蛋白及雌、孕激素受体的表达。ｂｃ１－２阳性３８例（７０．４％），Ⅰ、Ⅱ级肿瘤阳性３３例，Ⅲ、Ⅳ级肿瘤阳性５例（Ｐ＜０．０５）；Ｐ５３蛋白阳性１０例（１８．３％），对照组无一例阳性（Ｐ＜０．０５）；ＥＲ、ＰＲ阳性分别为２９例（５７．７％）、３９例（７３．７％）。ｂｃ１－２蛋白表达与ＥＲ、ＰＲ呈正相关（Ｐ＜０．０１，ｒ＝０．４５２），与Ｐ５３蛋白表达呈负相关（Ｐ＜０．０１，ｒ＝－０．４２１）。结果提示：ｂｃ１－２蛋白的表达有助于肾细胞癌预后的评估     

纤溶酶原激活物抑制物1与肝细胞癌

目的研究纤溶酶原激活物抑制物１（ＰＡＩ１）在肝细胞癌（ＨＣＣ）蛋白和ｍＲＮＡ水平的表达及其与ＨＣＣ生物学特性的关系。方法取ＨＣＣ石蜡标本４８例,肝良性肿瘤石蜡标本１２例（对照组）做免疫组化染色;液氮冻存ＨＣＣ标本２０例,肝血管瘤５例（对照组）做免疫印迹杂交。结果肝癌细胞与癌周细胞及对照组肝细胞相比,ＰＡＩ１抗原蛋白和ｍＲＮＡ表达显著升高,差异有显著意义,Ｐ值分别＜００１和＜０．０５。术后２年内死亡病例与生存病例相比,ＰＡＩ１阳性率有显著意义的升高,Ｐ＜００５。ＰＡＩ１和纤溶酶原激活物（ｕＰＡ）及其受体（ｕＰＡＲ）同时阳性患者与同时阴性患者相比,前者侵袭性病例较后者升高有显著性意义（Ｐ＜００５）。结论ＨＣＣ中ＰＡＩ１蛋白和ｍＲＮＡ表达明显增高。ＰＡＩ１与ＨＣＣ浸润转移和预后密切相关。     

胃肠道平滑肌肿瘤nm23表达与细胞增殖活性关系的研究

目的探讨ｎｍ２３表达与胃肠道平滑肌肿瘤（ＧＩＳＭＴ）良恶性、恶性程度、转移、预后及细胞增殖活性的关系。方法采用免疫组化法检测８６例ＧＩＳＭＴ患者ｎｍ２３的表达情况,采用胶银染色法及免疫组化法检测核仁组成区嗜银蛋白（ＡｇＮＯＲｓ）、增殖细胞核抗原（ＰＣＮＡ）来反映细胞的增殖活性。结果ｎｍ２３的表达按平滑肌瘤、低度恶性平滑肌肉瘤、高度恶性平滑肌肉瘤的顺序依次明显下降（Ｐ＜０．０１）。ｎｍ２３表达与肿瘤的良恶性生长方式、大小、中心有无坏死亦有明显的关系（Ｐ＜０．０１或Ｐ＜０．０５）。ｎｍ２３阳性表达组的５年生存率明显高于阴性表达组（Ｐ＜０．０５）。ｎｍ２３阴性组的ＡｇＮＯＲｓ和ＰＣＮＡ表达明显高于ｎｍ２３阳性表达组（Ｐ＜０．０１）。结论ｎｍ２３是反映ＧＩＳＭＴ生物学特性的良好标志物,与ＡｇＮＯＲｓ、ＰＣＮＡ可互补作为判断ＧＩＳＭＴ良恶性、恶性程度、转移及预后的客观指标。     

Immunohistochemical study on HLA expression of human breast cancer

One hundred and nine cases of breast cancer were examined by immunoperoxidase staining of frozen section for their HLA expression. Sixty one cases (56%) were negative or very weak for HLA class I expression, while normal mammary ductal epithelia showed intense positivity in both class I and class II antigens. The extent of expression correlated well with the histopathological subtyping of invasive ductal carcinoma in Japan, which reflects the prognosis quite well. Degree of lymphoid cell infiltration was also proportional to HLA expression by tumor cells. It may be that lack of HLA antigen expression leads to failure of induction of cytotoxic T cells, thus modulating the immunological response and influencing prognosis.     

Defective HLA Class I Expression and Patterns of Lymphocyte Infiltration in Chordoma Tumors

BackgroundThere are no effective systemic therapies for chordoma. The recent successes of immunotherapeutic strategies in other cancers have resulted in a resurgence of interest in using immunotherapy in chordoma. These approaches rely on a functional interaction between the host’s immune system and the expression of tumor peptides via the human leukocyte antigen (HLA) Class I antigen. It is not known whether chordoma cells express the HLA Class I antigen.Questions/purposes(1) Do chordoma tumors exhibit defects in HLA Class I antigen expression? (2) What is the pattern of lymphocyte infiltration in chordoma tumors?MethodsPatients with chordoma treated at Massachusetts General Hospital between 1989 and 2009 were identified with permission from the institutional review board. Of the 75 patients who were identified, 24 human chordoma tumors were selected from 24 distinct patients based on tissue availability. Histology slides from these 24 formalin-fixed paraffin-embedded chordoma tissue samples were deparaffinized using xylene and ethanol and underwent heat-induced antigen retrieval in a citrate buffer. Samples were incubated with monoclonal antibodies directed against HLA Class I antigen processing machinery components. Antibody binding was detected via immunohistochemical staining. Staining intensity (negative, weakly positive, strongly positive) was assessed semiquantitatively and the percentage of chordoma cells stained for HLA Class I antigen subunits was assessed quantitatively. Hematoxylin and eosin-stained histology slides from the same 24 chordoma samples were assessed qualitatively for the presence of tumor-infiltrating lymphocytes and histologic location of these lymphocytes. Immunohistochemical staining with monoclonal antibodies directed against CD4 and CD8 was performed in a quantitative manner to identify the lymphocyte subtype present in chordoma tumors. All results were scored independently by two investigators and were confirmed by a senior bone and soft tissue pathologist.ResultsSeven of 24 chordoma samples exhibited no staining by the anti-HLA-A heavy chain monoclonal antibody HC-A2, two had weak staining intensity, and eight had a heterogeneous staining pattern, with fewer than 60% of chordoma cells exhibiting positive staining results. Four of 24 samples tested were not stained by the anti-HLA-B/C heavy chain monoclonal antibody HC-10, five had weak staining intensity, and 11 displayed a heterogeneous staining pattern. For the anti-β-2-microglobulin monoclonal antibody NAMB-1, staining was detected in all samples, but 11 had weak staining intensity and four displayed a heterogeneous staining pattern. Twenty-one of 24 samples tested had decreased expression in at least one subunit of HLA Class I antigens. No tumors were negative for all three subunits. Lymphocytic infiltration was found in 21 of 24 samples. Lymphocytes were primarily found in the fibrous septae between chordoma lobules but also within the tumor lobules and within the fibrous septae and tumor lobules. Twenty-one of 24 tumors had CD4+ T cells and 11 had CD8+ T cells.ConclusionIn chordoma tissue samples, HLA Class I antigen defects commonly were present, suggesting a mechanism for escape from host immunosurveillance. Additionally, nearly half of the tested samples had cytotoxic CD8+ T cells present in chordoma tumors, suggesting that the host may be capable of mounting an immune response against chordoma tumors. The resulting selective pressure imposed on chordoma tumors may lead to the outgrowth of chordoma cell subpopulations that can evade the host’s immune system.Clinical RelevanceThese findings have implications in the design of immunotherapeutic strategies for chordoma treatment. T cell recognition of tumor cells requires HLA Class I antigen expression on the targeted tumor cells. Defects in HLA Class I expression may play a role in the clinical course of chordoma and may account for the limited or lack of efficacy of T cell–based immunity triggered by vaccines and/or checkpoint inhibitors.     

Down-regulation of HLA class I antigen is an independent prognostic factor for clear cell renal cell carcinoma

PURPOSE: We determined the prognostic impact of human leukocyte antigen class I on the survival of patients with clear cell renal cell carcinoma. MATERIALS AND METHODS: Immunohistochemical staining for HLA class I was performed on specimens from 45 patients with clear cell renal cell carcinoma. We performed univariate and multivariate analyses of various factors affecting cause specific survival including HLA class I, Fuhrman grade, TNM stage and tumor size. Furthermore, we compared the survival of patients with HLA class I positive renal cell carcinoma to that of those with down-regulated HLA class I using the Kaplan-Meier method and log rank test. RESULTS: HLA class I was immunohistochemically down-regulated in 17 (37.8%) clear cell renal cell carcinomas. The down-regulation had no correlation with other clinicopathological parameters such as tumor size, perirenal fat invasion, tumor thrombus, TNM stage or nuclear grade. Univariate and multivariate analyses revealed that HLA class I expression, tumor grade and TNM stage were significant factors influencing the disease specific survival of patients with renal cell carcinoma. Patients with HLA class I positive renal cell carcinoma had longer recurrence-free survival than those with down-regulated expression at 5-year followup (95.5% and 61.1%, respectively). CONCLUSIONS: Our data demonstrate that down-regulation of HLA class I on tumor cells is an independent prognostic factor for clear cell renal cell carcinoma. This finding suggests that HLA class I restricted cytotoxic T lymphocytes have an important role in the suppression of renal cell carcinoma.     

Expression and prognostic significance of HLA class I, ICAM-1, and tumor-infiltrating lymphocytes in esophageal cancer

Most solid malignancies show some degree of lymphoid infiltration suggesting a specific immunologic host vs. tumor reaction. Tumor-infiltrating lymphocytes (i.e., CD3+T-lymphocyte subsets), the human leukocyte antigen (HLA) class I molecules, and the intercellular adhesion molecule-1 (ICAM-1) are key factors involved in T-cell-mediated immune surveillance. The present study was designed to assess the expression pattern of intratumoral lymphocyte infiltrates and their relationship to HLA class I and ICAM-1 expression with regard to primary esophageal carcinoma and to evaluate their prognostic influence. Representative samples of primary tumors were obtained from 55 patients who had undergone radical en bloc esophagectomy. Frozen sections of these tumors were stained with monoclonal antibodies directed against CD3 for the assessment of tumor-infiltrating lymphocytes, HLA class I, and ICAM-1. The mean postoperative observation period was 19.5 months (range 5 to 45 months). Lymphocyte infiltration was absent in four tumors (8%), whereas 31 tumors (64%) showed moderate and 13 (27%) showed strong infiltration. HLA class I expression was deficient in 24 tumors (45%). Coexpression of HLA class I and ICAM-1 was significantly associated with lymphocyte infiltration of the tumor. Kaplan-Meier analyses revealed a significant beneficial influence on relapse-free survival for patients with lymphocyte infiltration of primary tumors compared to those with no lymphocyte infiltration of tumors (median 4 months vs. 18 months;P<0.002) and for HLA class I⁺ tumors compared to HLA class I⁻ tumors (median survival >18 months vs. 7 months;P=0.0081). The present data support the hypothesis that T-cell-mediated immunity may influence the fate of patients with esophageal cancer.     

睾丸肿瘤核仁组成区嗜银蛋白研究

为了解核仁组成区嗜银蛋白（ＡｇＮＯＲｓ）与睾丸肿瘤生物学行为的关系,作者应用核仁组成区嗜银蛋白计数及图像分析技术,对１０例正常睾丸组织及４９例睾丸肿瘤进行了研究。结果显示,Ａｇ－ＮＯＲｓ的数目、面积、平均面积、大颗粒数、圆度在正常及良、恶性肿瘤间有显著差异（Ｐ＜０．０１）。前四项参数随着肿瘤恶性程度增高而增大,且在预后差的肿瘤中比预后好的肿瘤大,而数目、面积、平均面积、圆度与睾丸肿瘤分期无关。大颗粒数在Ⅲ期比Ⅰ、Ⅱ期多,Ⅰ、Ⅱ期间无显著差异。作者认为,ＡｇＮＯＲｓ定量分析对睾丸肿瘤良恶性的区别、恶性程度的判断及预后的分析有较大的帮助,其中颗粒数目、面积及大颗粒数较敏感,而对睾丸肿瘤的分期意义不大。     

膀胱移行细胞癌中环氧化酶-2表达及其预后价值

目的探讨与膀胱移行细胞癌预后相关的新诊断方法。方法采用免疫组化SP法,检侧68例原发性膀胱移行细胞癌和10例正常膀胱组织标本环氧化酶-2(COX-2)的表达,结合临床资料,探讨其相互联系以及其表达与预后的关系。结果68例膀胱移行细胞癌组织中COX-2阳性表达率为63.2%(43/68),与病理分级、临床分期、血管浸润有关(P<0.05),而与淋巴结是否转移无显著性差异(P>0.05);对照组10例正常膀胱黏膜COX-2表达均为阴性;COX-2表达阳性生存超过5年者(54.1%)明显低于COX-2表达阴性者(91.3%)(P<0.05)。结论COX-2表达与膀胱移行细胞癌的恶性程度密切相关,检测COX-2表达对判断膀胱移行细胞癌预后有重要意义。     

HLA-I在乳腺癌组织中的表达及其临床意义

目的研究人类白细胞抗原-I类分子（HLA-I）在乳腺癌组织中的表达及其临床意义。方法采用免疫组织化学方法检测271例接受乳腺癌手术患者的乳腺癌组织中HLA-I的表达,并分析HLA-I的表达与乳腺癌临床病理特征及其预后的关系。结果271例患者中有92例（33.9％）乳腺癌组织中HLA.I呈强阳性表达,而179例（66.1％）的HLA.I表达下调;乳腺癌组织中HLA-I的表达与腋窝淋巴结转移、TNM分期、其他淋巴结转移及血管侵犯均相关（P〈0.05）。HLA-I表达阳性患者的无病生存率明显高于HLA-I表达下调者（P〈0.05）。结论检测乳腺癌组织中HLA-I的表达情况,对于预测肿瘤进展情况及其预后具有重要意义。     

HLA-A, -B, -C expression in colon carcinoma mimics that of the normal colonic mucosa and is prognostically relevant

Whether human leukocyte antigen (HLA)-A, -B, -C expression has any predictive value on the prognosis of human malignancies remains controversial. Herein, monoclonal antibodies with preferential reactivity for HLA-A, HLA-B, and HLA-C (HCA2, HC10, and L31) were used to stain an archival collection of 291 formalin-fixed/paraffin-embedded tissues, comprising neoplastic lesions from stages II and III colon carcinoma patients (n=165), and the uninvolved, morphologically normal mucosae from a subset (n=126) of these patients. Marked staining variability was detected not only in the tumors as in previous studies, but also in the normal paired mucosae. HLA-A, -B, -C expression was similar in approximately two thirds of the available 126 normal/neoplastic pairs, confirming in vivo our previous observation that most tumor cells mimic the HLA phenotypes of their normal counterparts. Both up and down-regulation occurred in the remaining third of the pairs, but did not coincide with high and low expression, respectively, conventionally evaluated on the tumor lesion only. Remarkably, a "paired" evaluation, but not high or low expression in the tumor, was predictive of the clinical outcome. Deviations from the expression in the normal paired mucosa (both increases and decreases) of HCA2-reactive class I molecules (possibly HLA-A), and down-regulation of L31-reactive class I molecules (possibly HLA-C), particularly in tumors from stage II patients, correlated with poor 5-year overall and disease-free survival, hazard risk ranging from 2 to 6, approximately. Thus, a paired immunohistochemical comparison reveals a novel immune evasion strategy that may impact on the prognosis of colon carcinoma.     

Clinical–pathological implication of human leukocyte antigen-F–positive gastric adenocarcinoma

Background

Human leukocyte antigen (HLA)-F is a nonclassical HLA class I molecule that shows aberrant expression in cancer cells. Although the clinical implications of HLA-F expression in cancer patients have been described, the specific significance of this antigen in gastrointestinal cancer remains unclear. The present study examined the expression pattern and clinical implications of HLA-F in gastric adenocarcinoma.

Patients and methods

HLA-F expression was assessed in 179 patients by immunohistochemistry, and its association with clinical parameters including patient survival was analyzed.

Results

HLA-F expression was positive in 30.7% (55/179) of patients and in 50.0% (90/179) of peritumoral infiltrating lymphocytes. HLA-F expression in gastric adenocarcinoma was significantly correlated with the depth of invasion, nodal involvement, and lymphatic and venous invasions (P < 0.01, all). HLA-F positivity of infiltrating cells near the tumor showed no correlation with clinicopathological features. HLA-F–positive patients had a significantly worse prognosis than HLA-F–negative patients (P = 0.012). However, HLA-F expression was not an independent prognostic factor in multivariate analysis.

Conclusions

The present study provides the first evidence that neo-HLA-F expression is of clinical significance in gastric adenocarcinoma. HLA-F expression in gastric adenocarcinoma may promote the aggressive behavior of tumors by suppressing the activity of antitumor immune effector cells.     

胃肿瘤中增殖细胞核抗原表达的临床研究

为了解增殖细胞核抗原（ＰＣＮＡ）在胃肿瘤中的表达及春临床意义，应用免疫组化技术（ＡＢＣ法）对胃肿瘤（胃腺瘤性息肉１０例，胃癌９４例）组织切片中ＰＣＮＡ含量进行半定量检测，结果。（１）胃粘膜不同病理状态下ＰＣＮＡ指数差异有极显著性意义（Ｐ〈０．０１）；（２）ＰＣＮＡ指数与患者的性别和年龄无关（Ｐ〉０．０５），而与肿瘤的生长方式，组织类型，浆膜层受侵与否，淋巴结转移与否和临床分期关系密切（Ｐ〈０．０５