胃癌p53,c—erbB—2和nm23癌基因蛋白的免疫组织化学研究

目的利用胃癌生物学恶性信息,探讨术前检测ｐ５３、ｃ－ｅｒｂＢ－２和ｎｍ２３蛋白对胃癌的诊断价值。方法收集胃癌手术标本１４１例,胃镜活检标本９３例,应用免疫组化技术检测ｐ５３、ｃ－ｅｒｂＢ－２和ｎｍ２３蛋白在上述组织中的表达。结果ｐ５３阳性率为４５．８％～５６．３％,ｃ－ｅｒｂＢ－２为１８．３％～３０．２％,ｎｍ２３为７２．９％～８１．３％,在非胃癌组织中无表达;ｃ－ｅｒｂＢ－２的表达与肿瘤组织的大小、癌细胞的分化程度及Ｌａｕｒéｎ分型有关,且ｃ－ｅｒｂＢ－２表达阳性组５年生存率低于阴性组;ｎｍ２３的表达与肿瘤的生长方式、浸润深度和淋巴结转移有关。三种癌蛋白的阳性率在胃癌的胃镜活检标本和手术标本中无显著差别。结论对胃癌组织进行ｐ５３、ｃ－ｅｒｂＢ－２和ｎｍ２３蛋白的检测,有助于胃癌的诊断、良恶性病变的鉴别诊断、非手术临床分期的判断和评估胃癌患者的预后。

Immunohistochemical study of p53, c-erbB-2 and nm23 proteins in human gastric cancer

OBJECTIVE: To evaluate p53, c-erbB-2 and nm23 oncoproteins in diagnosis of gastric cancer. METHODS: The expression of p53, c-erbB-2 and nm23 oncoproteins was detected immunohistochemically in 141 surgically resected specimens and 93 endoscopic biopsy specimens of gastric cancer. RESULTS: The positive rate of p53, c-erbB-2 and nm23 immunoreactivity was 45.8-56.3%, 18.3-31.2% and 72.9%-81.3% respectively. No immunoreactivity was observed in the tumor-adjacent normal mucosa and non-tumor biopsy specimens. The presence of c-erbB-2 was correlated with the size of tumor, grade of tumor differentiation and Lanren classification. Patients with c-erbB-2 positive tumor had lower 5-year survival rate. The expression of nm23 was negatively correlated with the depth of invasion, and lymphnode metastasis. The positive rates of p53, c-erbB-2 and nm23 had no statistical difference between biopsy and resected specimens. CONCLUSION: Determination of p53, c-erbB-2 and nm23 oncoproteins immunohistochemically might be useful in the diagnosis and differential diagnosis, clinical staging, and predicting prognosis of gastric cancer.