自然杀伤细胞在胃癌组织中的表达及临床意义

目的分析自然杀伤（NK）细胞在胃癌组织中的表达及其与胃癌临床病理特征和预后的关系。方法采用免疫组织化学染色法检测107例胃癌患者手术标本中NK细胞的表达，采用SAS9．12统计软件包进行资料分析。结果在胃癌、胃炎及胃息肉组织中均可见NK细胞的表达，但胃癌组NK细胞的表达（31．74±15．93）个／HPF]明显高于慢性胃炎组（5．02±2．55）个／HPF]和胃息肉组（4．84±1．55）个／HPF]，差异有统计学意义（P〈0．01）。NK细胞的表达与胃癌患者的性别、年龄、肿瘤部位、肿瘤大小、淋巴结转移、复发、病理分级、组织学类型和浸润深度均无统计学意义（P〉0．05），但TNM分期越高，NK细胞表达水平有明显下降的趋势，差异有统计学意义（P〈0．05）。与NK细胞低表达组相比，NK细胞高表达组胃癌患者中位生存时间延长14个月，两组生存曲线差异无统计学意义（χ2=2．888，P〉0．05）。多因素COX模型分析显示，与NK细胞低表达组相比，高表达组有降低胃癌死亡风险的趋势（RR=0．68，95％CI=0．41～1．23）。结论NK细胞的高表达与胃癌患者的生存时间呈正相关，可作为预测胃癌生存期的指标。

Clinical significance of NK cells in gastric carcinoma tissues

Objective To analyze the relationship between the expression of NK cells and the clinical patholog ie characteristics in gastric carcinoma tissues and its association with the prognosis of gastric carcinoma. Methods The expression of NK cells in 107 surgical specimens of gastric cancer tissues was detected by using immunohisto-chemistry assay,and the data was analyzed by using SAS 9.12. Results NK cells were expressed both in gastric carcinoma,gastritis and gastric polyp tissues, but the numbers of NK cells in gastric carcinoma tissues E（31. 74 ± 5.93 ）/HPF] was significantly higher than that in gastritis tissues （5.02 ±2.55）/HPF] and polyp tissues （4.84 ± 1.55） / HPF] （P%0.01 ）. No correlation was found between NK ceils count with gender, age, tumor location, tumor size, lymph node metastasis, tumor relapse, pathological grade, histological type and invasive depth（P〉0.05）. But the proportion of NK cell is obvious lower when tumor TNM staging is higher（P~0.05）. The median survival time of gastric cancer patients with NK cells high expression was 14 months longer than those with low expression, but the difference of survivorship curve was not statistically significant（χ2 = 2. 888 ,P〉0.05）. Multi factor COX model analysis demonstrated that the risk of death in gastric cancer patients was lower in the NK ceils high expression group than that in the low expression group（RR--0.68,95% CI：0. 41-- 1.23）. Conclusion There is a positive correlation between the high expression of NK cells and the survival time of gastric cancer patients, which may suggest that NK cells may be considered as a predictive index of gastric cancer patients.