p53和C—erbB-2的表达与胃癌浸润的多因素分析

目的探讨p53和c-erbB-2的表达与胃癌浸润的关系。方法收集139例胃癌手术切除标本，包括黏膜内癌23例、浸润至黏膜下层31例、浸润至肌层47例、浸润至浆膜或浆膜外38例，切片采用免疫组化sP法染色。采用多分类有序反应变量logistic回归进行统计分析。结果不同浸润深度的胃癌中p53的阳性率比较，黏膜内癌组和浸润至黏膜下层组与浸润至浆膜层或浆膜外组存在显著差异。而各组c—erbB-2的表达阳性率比较差异均有统计学意义（P〈0．01）。p53的表达强度在不同的浸润深度无统计学意义（P=0．149〉0．05）。c—erbB～2差别明显，在胃癌浸润至浆膜或浆膜外时，其表达强度最高（P=0．002〈0．01）。p53和C—erbB-2的阳性表达对胃癌的浸润均有促进作用（尸值分别为0．036、0．000）。p53和c—erbB-2的不同表达强度中，p5311I、c—erbB-2Ⅰ、c—erbB-2Ⅱ和c—erbB-2Ⅲ对胃癌浸润深度均有影响（P值分别为0．001、0．01、0．000、0．000）。结论抑癌基因p53突变可能与胃癌的起源有关；胃癌的浸润主要与癌基因c-erbB-2的激活有关。

Multivariate analysis on the expression of p53 and c- erbB- 2 and their relationship with tumor invasion in gastric cancer

Objective To explore the expression of p53 and c - erbB - 2 in gastric cancer and their relationship with tumor invasion. Methods SP immunohistochemistry was used to detect the positive rate and intensity of p53 and c - erbB - 2 expression in 139 gastric cancer excisional specimens. Ordinal logistic regression was used in statistical analysis. Results Compared with the positive rates of p53 in gastric cancer invaded different depth, only the distinction between the group of tumor invaded or exceeded serous membrane and the group of mucosal carcinoma or the group of submucous carcinoma was obvious. But the positive rate of c - erbB - 2 in each group was obviously dissimilar （P 〈0.01）. The intensity of p53 in gastric cancer invaded different depth had no obvious difference （P = 0. 149 〉0.05）. But c- erbB- 2 was obviously dissimilar. The intensity was highest at the time gastric cancer invaded or exceeded serous membrane （P = 0. 002 〈 0.01 ）. Ordinal logistic regression showed that the positive expression of p53 and c - erbB - 2 all promoted the invasion of gastric cancer （the value of P equaled respectively to 0. 036, 0. 000） ; but in the dif- ferent intensity of p53 and c - erbB - 2 expression, p53 Ⅲ, c - erbB - 2 Ⅰ , c - erbB - 2Ⅱ and c - erbB - 2 m could affect tumor invasion （the value of P equaled respectively to 0. 001, 0.01, 0. 000, 0. 000）. Conclusion The mutation of anti - oncogene p53 may relate to the origin of gastric cancer. The invasion of gastric cancer mostly relate to oncogene c - erbB - 2 activation.