肝肠钙粘蛋白在胃腺癌中的表达及其病理关系的研究

发布时间：2019-06-05 15:34

【摘要】：目的:胃癌是目前危害人类健康的常见恶性肿瘤之一,我国是胃癌发病率和死亡率最高的国家之一,发病率和死亡率均是世界平均水平的两倍多。黏附是肿瘤侵袭和转移过程中的一个重要环节,肿瘤侵袭和转移的第一步是肿瘤细胞的黏附分子发生变化,与钙黏蛋白有关的细胞间黏附分子与癌细胞的侵袭和转移过程密切相关,肝肠钙粘蛋白(liver intestine-cadherin,LI-cadherin,又称CDH17)作为一种钙依赖性跨膜糖蛋白,是钙黏蛋白家族的一位特殊成员,已成为近年来关注的一个研究热点。本研究通过检测LI-cadherin在胃腺癌中的表达,分析其在胃腺癌发生发展中的作用。方法:收集在哈励逊国际和平医院普外科2014年1月至2014年11月64例胃腺癌患者的手术切除癌组织、对应的癌旁正常组织及相应的临床资料,收集同期在哈励逊国际和平医院胃镜室活检的30例慢性萎缩性胃炎伴肠化及20例慢性萎缩性胃炎非肠化组织作为对照组,所有患者术前均未进行任何抗癌治疗。应用免疫组化(ABC)法检测64例胃腺癌组织及相应癌旁组织、30例慢性萎缩性胃炎伴肠化、20例慢性萎缩性胃炎非肠化组织中LI-cadherin的表达及相关性。采用SPSS13统计软件进行χ2检验统计学方法分析。结果:1 LI-cadherin在胃腺癌、癌旁正常组织、慢性萎缩性胃炎伴肠化、慢性萎缩性胃炎非肠化组织中阳性表达率分别为:53.12%、0%、90%、10%,癌组织与癌旁组织、慢性萎缩性胃炎伴肠化、慢性萎缩性胃炎非肠化组织两两比较均有显著差异性(P0.05)。LI-cadherin在胃腺癌中的表达与肿瘤分期、淋巴结转移、分化程度、胃壁浸润深度存在着较为显著的相关,具有统计学意义(P0.05);但与年龄、性别无明显相关(P0.05)。LI-cadherin在慢性萎缩性胃炎伴肠化组织中的表达与肠化生的分度有关(P0.05);但与年龄、性别无关(P0.05)。2基于WHO病理分型来看,LI-cadherin在管状腺癌、乳头状腺癌、粘液腺癌、印戒细胞癌中阳性表达率分别为:65.38%、55%、41.67%、16.67%,前三者两两比较无显著差异性(P0.05),印戒细胞癌与前三者两两比较均有显著差异性(P0.05)。基于Lauren病理分型来看,LI-cadherin在肠型胃癌、弥漫型胃癌中阳性表达率分别为:92.31%、26.32%,两组间存在着较为明显的差异,具有统计学意义(P0.05)。结论:LI-cadherin在慢性萎缩性胃炎伴肠化和胃癌组织中表达呈上调状态,LI-cadherin的异常表达可能与肠化生及胃癌的发生和发展有关,这意味着LI-cadherin的表达可能发生于胃癌的早期阶段,有可能成为一种新的诊断胃癌的标记物,对胃癌的早期诊断提供临床指导价值。
[Abstract]:Objective: Gastric cancer is one of the most common malignant tumors which are harmful to human health. adhesion is an important link in the process of tumor invasion and metastasis. The first step in the invasion and metastasis of the tumor is that the adhesion molecule of the tumor cell changes, and the cell adhesion molecule related to the calcium mucin is closely related to the invasion and metastasis of the cancer cell, and the liver-intestinal calcium-binding protein (liver insteine-cadherin), LI-cadherin, also known as CDH17, is a kind of calcium-dependent transmembrane glycoprotein, a special member of the family of calcium and mucin, and has become a focus of attention in recent years. The effect of LI-cadherin in the development of gastric adenocarcinoma was analyzed by detecting the expression of LI-cadherin in gastric adenocarcinoma. Methods:64 cases of gastric adenocarcinoma from January 2014 to November 2014 were collected and the corresponding adjacent normal tissues and corresponding clinical data were collected. 30 cases of chronic atrophic gastritis and 20 cases of non-intestinal tissue of chronic atrophic gastritis were collected as the control group, and no anti-cancer treatment was performed before the operation of all patients. The expression and correlation of LI-cadherin in 64 cases of gastric adenocarcinoma and 30 cases of chronic atrophic gastritis and 20 cases of chronic atrophic gastritis were detected by immunohistochemical (ABC) method. The statistical method of SPSS13 statistical software was used to analyze the statistical method. Results:1 LI-cadherin expression rate was 53.12%,0%,90%,10% respectively in gastric adenocarcinoma, adjacent to normal tissue, chronic atrophic gastritis, and in chronic atrophic gastritis. There was a significant difference between the expression of LI-cadherin in the gastric adenocarcinoma and the stage of the tumor, the degree of lymph node metastasis, the degree of differentiation and the depth of the infiltration of the gastric wall. The expression of LI-cadherin in chronic atrophic gastritis with intestinal metaplasia was related to the index of intestinal metaplasia (P0.05), but not related to age and sex (P0.05). The positive expression rates of signet-ring cell carcinoma were 65.38%,55%, 41.67% and 16.67%, respectively. There was no significant difference between the two groups (P0.05). The positive rate of LI-cadherin was 92.31% and 26.32%, respectively, and there was a significant difference between the two groups, which was statistically significant (P0.05). Conclusion: The expression of LI-cadherin in chronic atrophic gastritis with intestinal metaplasia and gastric cancer is up-regulated, and the abnormal expression of LI-cadherin may be related to the occurrence and development of intestinal metaplasia and gastric cancer, which means that the expression of LI-cadherin may occur in the early stage of gastric cancer. It is possible to be a new marker for the diagnosis of gastric cancer and to provide the clinical guidance value for the early diagnosis of gastric cancer.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.2

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