胃腺癌组织中IMP3 蛋白的表达及临床意义

目的 探讨IMP3 蛋白在胃腺癌（GAC）中的表达及意义。方法 选取2007 年2 月—2011 年2 月在丹东市第一医院行手术切除的92 例GAC 患者的组织蜡块标本，应用免疫组织化学染色检测其GAC及其癌旁胃组织，16 例转移淋巴结组织标本中IMP3 的表达，结合临床相关因素及生存数据进行分析。结果 GAC、癌旁组织及淋巴结组织中IMP3 阳性表达率分别为76.1%、50.0% 及87.5%，癌组织和转移淋巴结组织中IMP3 阳性表达率高于癌旁组织（P <0.05）；转移淋巴结组织中IMP3 强阳性表达率高于癌组织；GAC 组织中IMP3 阳性表达与Ki-67 表达、临床分期、是否有淋巴转移及是否侵犯浆膜层有关（P <0.05）；IMP3 阳性表达患者无病生存率及5 年生存率均高于阴性表达患者（P <0.05），且浆膜侵犯[H^R=1.851（95%CI ：1.180，2.906），P =0.000]、临床分期高[H^R=3.145（95% CI ：1.820，5.434），P =0.000]，IMP3 阳性表达是GAC 患者预后不良的独立危险因素[H^R=1.614（95% CI ：1.032，2.523），P =0.036]。结论 检测IMP3 蛋白表达水平对GAC 的诊断及预后评估有重要临床意义，有望成为GAC 新的标志物。

Clinical significance and expression of IMP3 proteinin gastric adenocarcinoma

Objectives To explore the clinical significance and expression of IMP3 in gastric adenocarcinoma(GAC). Methods Immuno-histochemical technique was adopted to detect the expression level of IMP3 protein in 92cases of gastric adenocarcinoma, 92 cases of adjacent tumor tissues, and 16 case of metastatic 1ymph nodes. Additionally,the relationship between the expression of IMP3 and the clinical prognostic factors was analyzed. Results IMP3 positiveexpression rates were 76.1%, 50.0% and 87.5% in the gastric adenocarcinoma, adjacent tumor tissues and 16 case ofmetastatic 1ymph nodes, respectively. IMP3 positive expression rate in gastric adenocarcinoma and metastatic 1ymphnodes was significantly higher than that in the adjacent tumor tissues (P < 0.05). The high-positive expression rate ofIMP3 in metastatic 1ymph nodes was higher than that in gastric adenocarcinoma. The expression rate of IMP3 wasclosely related to Ki-67 protein, stage, the lymphatic metastasis and serosal invasion (P < 0.05). Survival curve shows thatthe disease-free survival and 5-year survival rates of the patients with IMP3 high-expression were obviously lower than those of patients with IMP3 low-expression (P < 0.05). Importantly, serosal invasion, high stage, IMP3 high-expression rate was an independent risk factor for the prognosis of gastric adenocarcinoma [Hl^R=1.614 (95% CI: 1.032, 2.523), P = 0.036]. Conclusions Detection of IMP3 protein expression level has important clinical significance in the diagnosis and prognosis evaluation of GAC, and is expected to become a new marker of GAC.