Wnt/β-catenin及p38MAPK信号通路在人胃癌组织中的表达情况与化学治疗预后及多药耐药相关性研究

摘要

目的 研究Wnt/β-catenin及p38MAPK信号通路在人胃癌组织中的表达规律及其与患者病理情况、化疗后预后生存期情况、相关多药耐药因子之间相关性.方法 选取2007年11月至2013年7月大连医科大学附属第一医院胃癌根治术后病例共91例,应用免疫组化法,对已行胃癌根治术、相同化疗、随访的91名病例的病理标本进行检测,收集Wnt/β-catenin及p38MAPK表达情况和患者一般及病理情况、多药耐药因子ToPoⅡ和GST-π表达情况、预后生存期情况,并进行相关性分析.结果 Wnt/β-catenin及p38MAPK阳性表达率与年龄、性别、肿瘤分化程度、肿瘤分期无相关性;相同化疗后,中位生存时间Wnt/β-catenin阴性表达患者(26.5个月)比阳性表达患者(14.9个月)延长(P<0.05),p38MAPK阳性表达患者(29.1个月)比阴性表达患者(9.2个月)延长(P<0.05),经Log-Rank分析,Wnt/β-catenin阳性表达率与患者预后生存期呈负相关,p38MAPK阳性表达率与患者预后生存期呈正相关(P<0.05);p38MAPK阳性表达率分别与ToPoⅡ及GST-π阳性表达率呈正相关及负相关性(P<0.05),而Wnt/β-catenin阳性表达率与二者均无相关性(P>0.05);Wnt/β-catenin与p38MAPK阳性表达率之间无相关性(P>0.05).结论 Wnt/β-catenin 及p38MAPK 阳性表达率与年龄、性别、肿瘤分化程度、肿瘤分期无关;Wnt/β-catenin 阳性低表达及p38MAPK 阳性高表达与胃癌化疗预后生存期成正相关,可能降低了化疗药物的多药耐药性.%Objective To evaluate the expression of the Wnt/β-catenin and p38MAPK in gastric carcinoma and investigate their relationship with the pathological condition,survival time after thermotherapy,and the related factors of multidrug resistance.Methods 91 patients with gastric carcinoma treated with radical surgery from November of 2007 to July of 2013 in The First Affiliated Hospital of Dalian Medical University were selected as the research objects.The immunohistochemical method was used to assay the pathological specimen of the 91 patients with the same chemical treatment and the follow-ups.The data including the expressions of β-catenin,p38MAPK, ToPoⅡ and GST-π,the general and pathological condition of patients,and the survival prognosis were collected and analyzed.Results The positive expression rate of β-catenin and p38MAPK was not significantly correlated with age,gender,degree of tumor differentiation,and TNM staging respectively.After the same thermotherapy,the median survival time of the patients with the negative expression of β-catenin (26.5 months)was significantly longer than that of those with the positive expression (14.9 months)(P<0.05),while the median survival time of the patients with the positive expression of p38MAPK was significantly longer than that of those with the negative expression (P<0.05).According to the results of Log-rank analysis,the patients′survival time after prognosis was negatively correlated with the positive expression rate of β-catenin (P<0.05)and positively correlated with the positive expression rate of p38MAPK (P<0.05 );The positive expression rate of p38MAPK was positively correlated with that of GST-πand negatively correlated with that of ToPoⅡ,while the positive expression rate of β-catenin was not correlated with the positive expression rates of p38MAPK and ToPoⅡ respectively;and there were no correlation in the positive expression rate between β-catenin and p38MAPK.Conclusion The positive expression rates of β-catenin and p38MAPK are not correlated with age,gender,degree of tumor differentiation,and TNM staging respectively.The low positive expression of β-catenin and the high positive expression of p38MAPK are positively correlated with the survival time after prognosis and they may reduce the degree of multidrug resistance.