胃腺癌中nm23、P53的表达与Ki67增殖指数关系的研究

目的检测胃腺癌中nm23、P53和Ki67增殖指数的关系，分析其临床意义。方法以2010年3月~2013年6月我院收治的84例胃腺癌存档的蜡块组织作为观察组，选择45例正常胃黏膜组织作为对照组，应用免疫组化方法检测两组中nm23、P53和Ki67的表达水平；以阳性率为计数指标，结合患者临床资料，分析3种蛋白在肿瘤中表达的意义。结果观察组nm23表达的阳性率明显低于对照组，P53和Ki67表达的阳性率明显高于对照组（ P〈0.01）；观察组nm23的表达与肿瘤的分化程度、浸润深度和有无癌栓密切相关，P53的表达与肿瘤的淋巴结检出数量、浸润深度、肿瘤的最大径和分化程度密切相关，Ki67的表达与浸润深度和肿瘤的最大径密切相关（ P〈0.05或P〈0.01）。线性相关性分析显示，观察组nm23与P53、nm23与Ki67、P53与Ki67之间的表达均具有相关性。结论胃腺癌中nm23低表达、P53和Ki67高表达不仅可以促进肿瘤的发生，还可以促进肿瘤的进展，nm23和P53与Ki67的表达具有相关性。

Study on relationship of expression of nm23 and P53 with Ki67 proliferation index in gastric adenocarcinoma

Objective To study the relationship of the expression of nm23 and P53 with Ki67 proliferation index in gastric adenocarcinoma and analyze the clinical value. Methods The archived wax block tissues of 84 patients receiving treatment in our hospital from Mar. of 2010 to Jun. of 2013 for their gastric adenocarcinoma were selected as the observation group,and the normal gastric mucosa tissues of 45 patients of 84 ones were selected as the control group. Immunohistochemical method was used to detect the expression level of nm23,P53 and Ki67 of the patients in the two groups. Positive rate being taken as the estimated index,the expressed significances of the three proteins in tumors were analyzed in combination with clinical data. Results The expressed positive rate of nm23 in the observation group was significantly lower than that in the control group,and the expressed positive rates of P53 and Ki67 were significantly higher than those in the control group（P〈0. 01）;in the observation group,the expression of nm23 was closely related with the degree of differentiation and depth of infiltration of the tumor as well as the existence of cancerous thrombus,the expression of P53 was closely related with the detected counts of lymph node of tumor,the depth of infiltration,the maximum tumor size,and the degree of differentiation,and the expression of Ki67 was closely related with the depth of infiltration and the maximum tumor size（ P〈0. 05 or P〈0. 01）. Linear correlation analysis showed that there were linear correlations between the expressions of nm23 and P53, between nm23 and Ki67,as well as between P53 and Ki67 in the observation group. Conclusion Low expression level of nm23 and high expression level of P53 and Ki67 in patients with gastric adenocarcinoma will promote the occurrence and development of tumors, and nm23 and P53 have synergetic effects on the expression of Ki67.