受体型蛋白酪氨酸磷酸酶O及P53在胃癌中的表达及其与预后的关系

摘要

目的 检测受体型蛋白酪氨酸磷酸酶O(PTPRO)、P53蛋白在胃癌组织中的表达,分析其与临床病理特征及预后的关系.方法 回顾性分析2004年1月-2007年12月,在解放军总医院行D2根治术后并行氟尿嘧啶为主的辅助化疗4周期以上的Ⅱ-ⅢC期胃癌患者共61例,应用免疫组化法检测胃癌组织、癌旁组织和转移淋巴结中PTPRO蛋白表达,同时检测胃癌组织中P53蛋白表达,分析其与患者临床病理特征及预后的关系.结果 61例标本中,PTPRO在胃癌组织、癌旁组织、转移淋巴结中阳性率分别为65.6%、94.8%、65.9% (P<0.01);P53在胃癌组织阳性率为36.2%;P53表达与PTPRO表达无相关性(r=0.169,P=0.20).单因素分析显示,与临床分期晚、P53阳性的患者比较,P53阴性(P=0.022)、临床分期越早(P-0.000)的患者中位无病生存期(MDFS)越长(P<0.05);PS3阴性(P=0.001)、临床分期越早(P=0.001)的患者中位生存时间(MST)越长(P<0.05).多因素分析显示临床分期(P=0.001)、PTPRO蛋白表达(P=0.018)、P53蛋白表达(P=0.031)是影响胃癌术后患者DFS的独立影响因素,而临床分期(P=0.005)、PTPRO蛋白表达(P=0.014)、P53蛋白表达(P=0.033)、组织学分级(P=0.020)是影响其总生存期(0S)的独立影响因素.结论 PTPRO在胃癌组织中的表达显著减少.对于胃癌D2根治术后行氟尿嘧啶为主辅助化疗的患者,PTPRO和P53蛋白表达有望成为预测疗效的分子标记物.%Objective To determine the expression profiles of PTPRO and P53 in human gastric carcinoma tissue, and analyze the relationship of the expressions with clinicopathological characteristics and prognosis of patients with gastric carcinoma. Methods The clinical data of 61 patients with gastric carcinoma of stage Ⅱ-ⅢC. admitted to General Hospital of PLA from Jan. 2004 to Dec. 2007,having undergone D2 radical gastrectomy followed bv 5-FU-based adjuvant chemotherapy, were retrospectively analyzed.Immunohistochemistry was employed to examine the PTPRO expression in samples of primary tumor and paired normal tissue thereof, and lymph nodes with metastasis. The P53 expression in samples of primary tumor was also detected. The relation of P53 and PTPRO expressions to clinicopathological characteristics and prognosis of patients were analyzed. Results In 61 samples, PTPRO was expressed in primary tumor, paired normal tissue and lymph nodes with metastasis with a positive rate of 65.6％, 94.8％ and 65.9％, respectively (P＜0.01). P53 was expressed in primary tumor with a positive rate of 36.2％. No correlation existed between p53 expression and PTPRO expression ( r=0.169, P=0.20) . Kaplan-Meier survival analysis showed that the median disease-free survival time (MDFS) was longer in patients with negative P53 expression (P=0.022) and early stage carcinoma ( P=0.000), and the median survival time (MST)was also longer in patients with negative P53 expression ( P=0.001) and early stage carcinoma ( P=0.001). Cox regression analysis showed that the clinical stage (P=0.001) , PTPRO and P53 expressions (P=0.018, P=0.031) were the independent prognostic factors for disease-free survival (DFS), and clinical stage ( P=0.05), PTPRO and P53 expressions ( P=0.014, P=0.033) and pathological stage (P=0.020) were independent prognostic factors for over survival (OS). Conclusions The expression of PTPRO is notably decreased in gastric carcinoma. The expression of PTPRO and P53 proteins are expected to be molecular markers for predicting the prognosis of patients with gastric carcinoma who received 5-FU-based adjuvant chemotherapy after D2 radical gastrectomy.