TP/PD-ECGF表达与血小板增多在胃癌中的意义

摘要

目的:研究血小板衍化内皮细胞生长因子(TP/PD-ECGF)在胃癌中的表达及血小板增多情况,并对其与胃癌患者临床病理特征和预后的关系进行探讨.方法:采用免疫组化EnVision两步法检测107例胃癌组织中TP/PD-ECGF的表达,记录血小板增多情况,并分析二者与胃癌患者临床病理特征及预后的关系.结果:胃癌患者中TP/PD-ECGF阳性表达率为71.0%,与血小板增多呈正相关(P<0.01).TP/PD-ECGF表达、血小板增多与肿瘤分期、淋巴结转移、远处转移及分化程度呈正相关.TP/PD-ECGF阳性与阴性表达患者3年、5年总生存率分别为69.04%、18.12%和88.87%、75.20%,二者差异有统计学意义(P=0.0383);3年、5年无进展生存率分别为64.87%、17.92%和82.73%、35.00%,二者差异有统计学意义(P=0.0350).Cox比例风险模型多因素分析显示,肿瘤分期、淋巴结转移、远处转移、TP/PD-ECGF及血小板增多均是影响胃癌预后独立的危险因素.结论:TP/PD-ECGF表达与血小板增多呈正相关,二者与胃癌生长和浸润转移关系密切,可作为胃癌独立的预后因素.%Objective: Thymidine phosphorylase/Platelet - derived endothelial cell growth factor ( TP/PD ECGF ) has shown to be up - regulated in several cancers and to play an important role in angiogenesis and invasion of solid tumors. This study was to detect the expression of TP/PD - ECGF and the platelet count, and investigate their influence on the clinicopahtological characteristics and the prognosis in gastric carcinoma patients. Methods: The expression of TP/PD - ECGF in 107 specimens of gastric carcinoma was examined by EnVision immunohistochemistry, and the platelet count of all patients were recorded. The correlation of the expression of TP/PD - ECGF and thromhocytosis to clinicopathological characteristics and prognosis in gastric carcinoma patients were analyzed. Results : The positive expression rate of TP/PD - ECGF was 71. 0％ in gastric carcinoma, and positively correlated to thrombocytosis( P ＜0.01 ). The expression of TP/PD - ECGF and thrombocytosis were positively correlated to the stage of primary tumor, lymph node metastasis , distant metastasis and histological grade. 3 - year and 5 - year overall survival rates were significantly lower in the patients with positive expression of TP/PD - ECGF than in those with negative expression of TP/PD - ECGF ( 69. 04％ vs. 88. 87％ , 18. 12％ vs. 75. 20％ ,P = 0. 0383 ). The 3 - year and 5 - year progression - free survival rates were significant lower in the patients with positive expression of TP/PD - ECGF than in those with negative expression of TP/PD - ECGF( 64. 87％ vs. 82. 73％ , 17. 92　％ vs. 35. 00％ , P = 0. 0350 ). Multivariate Cox model analysis showed that the stage of primary tumor, lymph node metastasis , distant metastasis , TP/PD - ECGF and thromhocytosis were independent prognostic factors for the patients with gastric carcinoma, but age, sex, tumor size and histological grade were not. Conclusion : Expression of TP/PD - ECGF is positively correlated to thrombocytosis, and both of them are related with the growth, invasion and metastasis of gastric carcmoma, and they are independent prognostic indicators of survival in patients with gastric carcinoma.