胃癌组织DNA拓扑异构酶2α等8种分子的蛋白表达与脉管侵犯的关系

目的: 研究DNA拓扑异构酶2α（TOP2A）等8种分子在伴脉管侵犯胃癌患者中的蛋白表达。方法: 回顾性分析242例胃腺癌患者的临床资料，免疫组化检测其石蜡包埋肿瘤组织中TOP2A、微管蛋白β3、胸苷酸合酶(TS)、非转移蛋白23（NM23）、P糖蛋白、增殖标记Ki-67、切除修复交叉互补酶1（ERCC1）及人类表皮生长因子受体2（HER2）的蛋白表达，比较有和无脉管侵犯者之间上述分子标志物表达的差异。结果： 81例（33.5%）患者有脉管侵犯，其中女性、肿瘤最大径≥5 cm、伴神经侵犯及TNM分期Ⅲ-Ⅳ期患者的比例均显著高于无脉管侵犯者（P<0.05）。有脉管侵犯者的TOP2A高表达率（89.3%）显著高于无脉管侵犯者（72.9%，P<0.05），而微管蛋白β3、TS、NM23、P糖蛋白、Ki-67、ERCC1及HER2的高表达率在两组间差异均无统计学意义（P>0.05）。亚组分析显示，有和无脉管侵犯者之间TOP2A高表达率的差异主要出现于女性（100% vs 72.2%，P=0.045）和组织学分级Ⅲ级的患者中（89.3% vs 67.6%，P=0.040）。 结论： 有脉管侵犯胃癌患者的TOP2A高表达率显著高于无脉管侵犯者，提示TOP2A在脉管侵犯中起作用。

Relationship between protein expression of eight molecules including DNA topoisomerase 2α and lymphovascular invasion in gastric cancer patients

Objective: To investigate the protein expression of eight molecules including DNA topoisomerase 2α (TOP2A) in gastric cancer patients with lymphovascular invasion. Methods: A retrospective study was conducted in 242 patients with gastric adenocarcinoma. The protein expressions of TOP2A， tubulin β3, thymidylate synthase(TS), nonmetastatic protein 23(NM23), P glycoprotein, proliferation marker Ki 67,excision repair cross complementation group 1(ERCC1) and human epidermal growth factor receptor 2(HER2) in paraffin embedded tumor tissues were detected by immunohistochemistry and were compared between patients with and without lymphovascular invasion. Results: Lymphovascular invasion was detected in 81 patients (33.5%), and the proportions of female patients, patients with the longest diameter of tumor≥5 cm, nerve invasion and TNM stages of Ⅲ-Ⅳ were significantly higher in these patients than that in patients without lymphovascular invasion(P<0.05). The high expression rate of TOP2A protein in patients with lymphovascular invasion（89.3%） was significantly higher than that in those without lymphovascular invasion(72.9%，P<0.05), and this difference was mainly found in subgroups of female(100% vs 72.2%，P=0.045) and histological grade of Ⅲ (89.3% vs 67.6%，P=0.040). The high expression rates of tubulin β3, TS, NM23, P glycoprotein, Ki 67, ERCC1 and HER2 protein were not significantly different between these two groups(P>0.05). Conclusion: Gastric cancer patients with lymphovascular invasion had a significantly higher expression rate of TOP2A protein compared with those without lymphovascular invasion, suggesting the role of TOP2A in lymphovascular invasion.