RhoA在胃癌的表达意义及对预后和生存的影响

发布时间：2018-04-01 16:44

  本文选题：胃癌　切入点：RhoA　出处：《济南大学》2017年硕士论文

【摘要】：目的:检测胃癌(GC)组织中RhoA的表达情况,分析其在GC组织中的表达及其意义;结合随访资料进行生存分析,探讨RhoA与GC患者预后和生存的关系。方法:收集山东省医学科学院附属医院89例保存完好的术后胃癌组织石蜡标本为研究对象,用免疫组化方法检测RhoA在胃癌的表达,分析RhoA的表达与临床病理特征之间的关系,并取相应胃癌癌旁组织49例和同期正常胃粘膜组织标本19例作为对照组,随访患者并进行生存和预后分析。结果:1.采用IHC方法检测RhoA在人胃癌组织的表达,RhoA在胃癌组织、相应癌旁组织、对照组中阳性率分别是71.9%(64/89)、46.9%(23/49)和26.3%(5/19)。RhoA在胃癌组织与癌旁组织间、胃癌组织与正常胃粘膜组织间的阳性率差别有统计学意义(P0.05),癌旁与正常胃组织的阳性率差别无统计学意义(P0.05)。2.RhoA的表达与胃癌的分化程度、有无淋巴结转移、TNM分期及Lauren分型有相关性(P0.05),与年龄、性别、肿瘤直径大小无相关性。3.随访时间为12-60月,胃癌患者术后平均生存期为29.5±1.1个月,RhoA表达阳性患者的平均生存期为27.7±1.2个月,RhoA表达阴性的患者平均生存期为33.6±2.1个月,经Log-rank检验两者的生存期有明显差异(P0.05),RhoA阳性表达的生存期明显低于RhoA阴性表达的生存期。肠型胃癌的平均生存期为32.8±1.8个月,弥漫型胃癌的平均生存期为26.4±1.5个月,混合型胃癌的平均生存期为28.6±2.6个月,经Log-rank检验三者的生存期有明显差异(P0.05),弥漫型胃癌患者的生存期明显低于肠型胃癌患者的生存期,混合型胃癌的生存期居于两者之间。在肠型胃癌患者RhoA表达阳性的患者平均总生存期为29.6±2.1个月,RhoA表达阴性的患者平均总生存期为36.6±2.8个月(P0.05);在弥漫型胃癌患者中RhoA表达阳性的患者平均总生存期为25.3±1.7个月,RhoA表达阴性的患者平均总生存期为30.3±3.1个月(P0.05);同样,经Log-rank检验,低分化、有淋巴结转移和TNM分期Ⅲ+Ⅳ期的胃癌患者平均生存期低于高+中分化、无淋巴结转移和TNM分期Ⅰ+Ⅱ期的患者(p0.05),不同性别、不同年龄分段,不同肿瘤直径大小的患者平均生存期之间无显著性差异(p0.05),平均生存期接近。表明RhoA表达与否,劳伦分型,分化程度,淋巴结转移、TNM分期对胃癌患者的生存期有显著的影响,影响患者的预后。结论:RhoA在胃癌组织中高表达,与肿瘤的侵袭和转移能力有关,影响胃癌患者的生存及预后,RhoA检测有望成为新的作用靶点,减少化疗耐药。
[Abstract]:Objective: to detect the expression of RhoA in gastric cancer tissues, analyze its expression and its significance, and analyze the survival of GCCs with follow-up data. To investigate the relationship between RhoA and prognosis and survival of GC patients. Methods: 89 paraffin specimens of gastric cancer tissues were collected from affiliated Hospital of Shandong Academy of Medical Sciences, and the expression of RhoA in gastric cancer was detected by immunohistochemical method. To analyze the relationship between the expression of RhoA and clinicopathological features, 49 cases of adjacent tissues of gastric cancer and 19 cases of normal gastric mucosa were taken as control group. The survival and prognosis of the patients were followed up. Results 1. The positive rates of RhoA expression in gastric cancer tissues and adjacent tissues were 71.9% and 46.9%, respectively. The positive rates of RIA and 26.3%(5/19).RhoA in gastric cancer tissues and adjacent tissues were 71.9% and 71.9%, respectively, and the positive rates of 26.3%(5/19).RhoA in gastric cancer tissues and adjacent tissues were 71.9% and 71.9%, respectively. There was significant difference in the positive rate between gastric cancer and normal gastric mucosa (P 0.05). There was no significant difference between adjacent gastric cancer and normal gastric tissue. 2. RhoA expression and differentiation of gastric cancer. There was no correlation between TNM staging and Lauren classification with or without lymph node metastasis. There was no correlation between TNM staging and age, sex and tumor diameter. The follow-up time was 12 to 60 months. The average survival time of patients with positive expression of RhoA was 27.7 卤1.2 months, and the average survival time of patients with negative expression of RhoA was 33.6 卤2.1 months. There was a significant difference in survival time between the two groups by Log-rank test. The average survival time of intestinal type gastric cancer was 32.8 卤1.8 months, and that of diffuse gastric carcinoma was 26.4 卤1.5 months. The average survival time of mixed gastric cancer was 28.6 卤2.6 months. There was a significant difference among the three groups by Log-rank test. The survival time of diffuse type gastric cancer patients was significantly lower than that of intestinal type gastric cancer patients. The average total survival time of mixed gastric cancer patients with positive RhoA expression was 29.6 卤2.1 months, the average total survival time of patients with negative RhoA expression was 36.6 卤2.8 months (P 0.05) and that of diffuse gastric cancer patients with RhoA was 36.6 卤2.8 months. The average total survival time of the patients with positive expression of RhoA was 25.3 卤1.7 months. The average total survival time of the patients with negative expression of RhoA was 30.3 卤3.1 months. By Log-rank test, the average survival time of patients with poorly differentiated gastric cancer with lymph node metastasis and TNM stage 鈪，

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