胃癌细胞凋亡与增殖的细胞转换与生存的关系

目的：探讨胃癌细胞中凋亡与增殖的细胞转换（AI/PI）的变化以及与生存的关系。 方法： 应用流式细胞仪，分别定量分析细胞的凋亡群体(AI)和增殖群体(PI)；共聚焦显微镜对细胞增殖进行形态学观察；Kaplan-Mier法分析生存率。 结果： 肿瘤细胞凋亡与增殖经Pearson检验两者呈正相关，相关系数r=0.58（P<0.01）。在肿瘤细胞的临床病理特征中，AI/PI总体呈下降的趋势(与淋巴转移、远处转移相关，P<0.05)。胃癌细胞AI/PI的表达与肿瘤患者不同存活时间之间无显著差异。根据AI/PI的中位数值0.245，将胃癌细胞分为>0.245组和<0.245组。结果显示两组Kaplan-Meier生存曲线经Log-rank检验无显著差异（P>0.05）。共聚焦显微镜显示肿瘤组织中Ki-67高表达。 结论： 肿瘤细胞凋亡与增殖密切相关；随着肿瘤细胞的恶性进展，AI/PI总体呈下降的趋势；AI/PI不是评价预后的指标。

Measures of cell turnover (apoptosis and proliferation) and their association with survival in gastric cancer

AIM: To investigate the ratio of apoptotic index and proliferative index (AI/PI) in gastric cancer and their association with survival. METHODS: The apoptotic population and the proliferative population were quantitatively analyzed by flow cytometry. The proliferative cells were identified by confocal microscope and Kaplan-Meier method was used to analyze survival. RESULTS: AI and PI were strongly correlated with a Pearson coefficient of 0.58 (P<0.01). A stepwise decrease trend in AI/PI was noted in clinical pathological variables, including lymph node metastasis and beyond metastasis (P<0.05 for each). No statistically significant difference in AI/PI expression based on different survival times was observed. Using the median AI/PI of 0.245, the cells were divided into two groups (greater than and less than the median AI/PI). Using Kaplan-Meier survival curves and the Log-rank test, no statistic difference was found in two groups. The high expression of Ki-67 in tumor was found by confocal microscope. CONCLUSION: AI and PI are significantly correlated. A stepwise decrease trend in AI/PI may exist in tumor progression. AI/PI may not be good as a prognostic factor for cancer evaluation.