CD133、SPARC和ARID1A在胃癌中的表达及临床意义

目的 探讨CD133、富含半胱氨酸的酸性分泌蛋白（SPARC）和AT丰富结构域1A（ARID1A）在胃癌组织中的表达及其与临床病理特征和预后的关系。方法 采用免疫组化法检测90例胃癌组织中CD133、SPARC和ARID1A的表达情况，分析其与胃癌临床病理特征及预后的关系。结果 胃癌组织中CD133、SPARC和ARIDIA的阳性表达率分别为26. 7％（24／90）、72.2％（65／90）和30.0％（27／90）。3种蛋白的表达与性别、年龄、肿瘤大小均无关，与TNM分期有关（P＜0.05）。ARID1A的表达与肿瘤浸润深度、分化程度相关（P＜0.05）；CD133的表达与分化程度、脉管侵犯、淋巴结转移、肿瘤原发部位有关（P＜0.05）；SPARC的表达与淋巴结转移及脉管侵犯有关（P＜0.05）。Cox多因素分析显示，TNM分期、术后辅助化疗周期、ARID1A和SPARC的表达是影响患者无病生存期（DFS）的独立因素，而TNM分期、术后辅助化疗周期及CD133的表达是影响总生存期（OS）的独立预后因素。CD133阳性表达者的中位DFS和OS分别为12个月和17个月，阴性表达者分别为41个月和55个月，差异均有统计学意义（P＜0.05）。SPARC高表达者的中位DFS和OS分别为41个月和54个月，高于低表达者的10个月和25个月，差异均有统计学意义（P＜0.05）。ARID1A阳性表达者的中位DFS和OS未达，阴性表达者分别为20个月和37个月，差异均有统计学意义（P＜0.05）。结论 CD133、SPARC、ARID1A可能在胃癌的发生、侵袭、转移中发挥重要作用，检测其在胃癌组织中的表达，有助于判断预后，为胃癌治疗提供依据。

Expression of CD133,SPARC and ARID1A in gastric cancer and its clinical significance

Objective To analyze the expression of CD133, secreted protein acidic and rich in cysteine（SPARC）, and AT rich interactive domain1A（ ARID1A） in gastric cancer and their relationship with clinicopathological features and the prognosis of gastric cancer. Methods Expression of CD133, SPARC and ARID1A proteins were detected by immunohistochemistry （IHC）, and its correlation with clinicopathologic features and survival of gastric cancer was analyzed. Results The positive rates of CD133, SPARC and ARID1A was 26.7%（24/90）, 72.2%（65/90）and 30.0%（27/90） in gastric cancer. The expression of CD133, SPARC and ARID1A was not re-lated to sex, age and tumor size, but all related to TNM stage（P〈0.05）. The expression of ARID1A was also related to the depths of tumor invasion and tumor differentiation（P〈0.05）; the expression of CD133 was related to tumor differentiation, vascular invasion, lymph node metastasis and tumor position（P〈0.05）;the expression of SPARC was related to lymph node metastasis and vascular invasion （P〈0.05）. Cox analysis showed that TNM stage, chemotherapy after surgery, and the expression of ARID1A and SPARC were independ-ent prognostic factors influencing disease free survival （ DFS）;TNM stage, chemotherapy after surgery and the expression of CD133 were independent prognosis factors for overall survival （ OS） . The median DFS and OS were 12 months and 17 months with positive expression of CD133, while in positive expression they were 41 months and 55 months with significance （ P〈0.05） . The median DFS and OS with high SPARC expression levels was 41 and 54 months, higher than 10 months and 25 months in low expression （P〈0.05）. The median DFS and OS with positive ARID1A expression were not achieved, but higher than 20 months and 37months （ P〈0.05） . Conclusion Detecting the expression of CD133, SPARC, and ARID1A contributes to the prediction of the prognosis of gastric cancer and selection of ad-juvant chemotherapy for priority patients, and provides evidence for the therapy of gastric cancer.