胃癌组织表皮生长因子受体和下游信号的表达及临床意义

目的 检测胃癌组织中表皮生长因子受体(EGFR)、蛋白激酶B(AKT)、细胞外信号调节激酶(ERK)的表达,探讨3种蛋白在胃癌发生发展及侵袭、转移中的作用.方法 采用免疫组织化学方法(SP法)检测84例胃癌组织及15例正常胃组织中EGFR、AKT、ERK的表达,分析EG-FR、AKT、ERK的表达与胃癌患者临床病理特征及预后的关系.结果 (1)在84例胃癌组织中EG-FR、AKT、ERK过表达率分别为29.7%、31.0%和33.3%,正常胃组织的过表达均为0,差异有统计学意义(P<0.05);(2)Ⅲ+Ⅳ期患者AKT过表达率为39.7%,明显高于Ⅰ+Ⅱ期患者(11.5%)(P<0.01);(3)T3+T4组AKT的过表达率为37.9%,明显高于T1+12组(5.6%)(P<0.01);淋巴结阳性者AKT的阳性率为40.4%;明显高于阴性者(18.9%)(P<0.05).(4)EGFR、AKT、ERK过表达者总生存及无进展生存期明显低于低表达者.结论 检测胃癌组织中的EGFR、AKT、ERK表达,有助于胃癌的诊断及对胃癌的恶性程度的判断和预后的评估.

Expression and clinical significance of epidermal growth factor receptor and its down-stream signal in gastric carcinoma

Objective To analyze the relationship between the survival and expressions of epidermal growth factor receptor (EGFR), AKT and extracellular signal-regulated kinase (ERK), and explore the prognostic significance of EGFR, AKT and ERK in gastric cancer patient by detecting the expression of EGFR, AKT and ERK in gastric carcinoma specimens. Methods EGFR, AKT and ERK were detected by immunohisto-chemistry. The relationship between the expression of EGFR, AKT and ERK with the clinical characteristics and prognosis was analyzed. Results (1) The over-expression rate of EGFR, AKT and ERK was 29.7%, 31.0% and 33.3% respectively in84 cases, and that was 0 in 15 normal gastric tissue (all P<0.05); (2) The AKT over-expression rate in patients with HI + IV stages was 39.1% , significantly higher than 11.5% in patients with Ⅰ+Ⅱ stages (P<0.01) ; (3) The AKT over-expression rate in patients with T3 +4 groups was 37.9% , significantly higher than 5.6% in those with Tl +2 groups (P <0.01). The AKT over-expression rate in patients with positive lymph node was 40.4%, significantly higher than 18.9% in those with negative lymph node (P < 0.05) ; (4) The OS and PFS in patient with low-expression of EGFR, AKT and ERK were significantly longer than in those with over-expression. Conclusion The over-expression of EGFR, AKT and ERK could be used to diagnose and evaluate the degree of differentiation and prognosis of patients with gastric carcinoma.