胃癌组织中CD133的表达及其临床意义

目的研究胃癌组织中CD133表达的相互关系,重点明确术前、术后外周血单核细胞中CD133mRNA表达的临床意义及其与胃癌原发灶CD133表达的关系。方法 50例胃癌、10例胃溃疡穿孔及10名健康自愿者入组研究。胃癌患者术前和术后1周抽外周静脉血各4 ml,密度梯度离心法分离单核细胞,半定量逆转录聚合酶链反应(RT-PCR)检测CD133 mRNA表达水平。胃溃疡穿孔患者术前抽外周静脉血、健康自愿者抽晨血各4 ml。胃癌原发灶及癌旁正常胃黏膜组织分别行RT-PCR、免疫组织化学染色检测CD133 mRNA和蛋白的表达。分析CD133表达对各临床病理特征和预后的影响。结果健康自愿者及术前胃溃疡患者及胃癌患者外周血中CD133 mRNA的半定量值分别为0.029±0.060、0.059±0.099及0.270±0.163(P=0.000)。胃癌患者术前外周血CD133 mRNA表达与肿瘤组织分化程度、淋巴管浸润、肿瘤浸润深度、淋巴结转移及TNM分期均有关(P<0.05)。相关分析显示,胃癌患者术前外周血中CD133 mRNA半定量值与淋巴结转移率(rs=0.422,P=0.002)、癌转移淋巴结枚数(rs=0.398,P=0.004)呈正相关,并与胃癌原发灶中CD133 mRNA的表达呈正相关(rs=0.337,P=0.017)。胃癌原发灶中CD133蛋白表达阳性者,术前外周血中CD133 mRNA的半定量值较CD133蛋白表达阴性者高(Z=-2.539,P=0.011)。50例胃癌患者行胃癌根治术后1周,其外周血中CD133 mRNA半定量值明显高于术前CD133 mRNA的表达水平(P=0.021)。胃癌浸润深度较深者,术后CD133 mRNA表达升高更明显(Z=-1.978,P=0.039)。术后外周血中CD133 mRNA高表达者较低表达者预后更差(χ2=6.193,P=0.013)。结论胃癌患者术前外周血高表达CD133 mRNA,其与肿瘤分化程度、淋巴管浸润、肿瘤浸润深度、淋巴结转移、TNM分期及胃癌原发病灶CD133蛋白表达有关,且与淋巴结转移率、癌转移淋巴结枚数及胃癌原发灶中CD133 mRNA的表达呈正相关。术后患者外周血中CD133 mRNA半定量值较术前明显升高,这一升高提示肿瘤浸润程度较深,患者预后较差。

Expression of CD133 in Gastric Adenocarcinoma Tissue and Its Clinical Significance

Objective To study the expression of CD133 mRNA in peripheral blood mononuclear cells(PBMCs) of patients with gastric adenocarcinoma(GC) before operation or after operation and its clinical significance.To learn the relationship of CD133 expressions in PBMCs to primary lesion of GC.MethodsFifty patients with GC,10 patients with gastric ulcer(GU),and 10 healthy volunteers were registered in this research.Expressions of CD133 mRNA in PBMCs and in primary lesion of GC by semi-quantitative RT-PCR and expression of CD133 protein in primary lesion of GC by immunohistochemical staining were detected.Correlations of CD133 mRNA expression with clinicopathologic parameters and postoperative survival rate were analyzed.Relation between CD133 mRNA level and CD133 protein expression or lymphatic metastasis were assessed too.ResultsThe brightness scale value(ABSV) of CD133 mRNA in PBMCs of the patients with GC before operation(0.270±0.163) was higher than that in the healthy volunteers(0.029±0.060) or in the patients with GU(0.059±0.099)(P=0.000).The ABSV of CD133 mRNA in the PBMCs of patients with GC before operation was related to poor cell differentiation(P=0.002),lymph vessel invasion(P=0.028),deeper tumor invasion(P=0.041),later lymph node metastasis stage(P=0.010),later TNM stage(P=0.006),and positive expression of CD133 protein in the primary lesion(P=0.011).Relative analysis revealed that the ABSV of CD133 mRNA in the PBMCs of patients with GC before operation was related positively to metastatic lymphatic nodes ratio(rs=0.422,P=0.002),metastatic lymph node number(rs=0.398,P=0.004),and ABSV of CD133 mRNA in the primary lesion of GC(rs=0.337,P=0.017).The ABSV of CD133 mRNA in the PBMCs of patients with GC after operation obtained from blood sample at 1 week after curative resection was higher than that in the patients before operation(P=0.021).Patients suffered from deeper invasion inclined to have a higher ABSV of CD133 mRNA after surgery(P=0.039).Higher expression of CD133 mRNA in patients after operation demonstrated a much poorer survival rate(P=0.013).Conclusions Higher expressive level of CD133 mRNA in GC before operation is associated to poor cell differentiation,lymph vessel invasion,deeper invasion,higher lymph node metastasis,later TNM stage,and positive expression of CD133 protein.It is also related positively to metastatic lymphatic nodes ratio,metastatic lymph node number,and ABSV of CD133 mRNA in primary lesion of GC.The level of CD133 mRNA in PBMCs of patients with GC is higher after operation as compared with before operation,which demonstrates deeper invasion and poorer survival.