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目的:探讨与胃左动脉(No.7)、肝总动脉(No.8a、No.8p)、腹腔干(No.9)周围淋巴结转移相关的基因异常表达及临床病理学相关性因素。方法:采用回顾性研究方法分析70例行D2、D3根治术的原发胃癌(单病灶)患者的临床病理资料,采用免疫组化染色方法检测70例胃癌原发灶中增殖细胞核抗原(PCNA)和Ki-67增殖指数(LI)、P53、C-erb B2、Survivin、基质金属蛋白酶-2(MMP-2)、MMP-7及MMP-9的表达及其与胃左动脉淋巴结(No.7)、肝总动脉淋巴结(No.8a、No.8p)、腹腔干淋巴结(No.9)转移的关系。结果:单因素分析显示肿瘤大小、浸润深度、累及淋巴结站别、淋巴管浸润、Ki-67 LI、C-erb B2、MMP-7、MMP-2的表达与胃左动脉淋巴结(No.7)、肝总动脉淋巴结(No.8a、No.8p)、腹腔干淋巴结(No.9)转移有关(P<0.05)。多因素分析显示淋巴管浸润、Ki-67 LI增高和MMP-7及MMP-2阳性是胃癌胃左动脉淋巴结(No.7)、肝总动脉淋巴结(No.8a、No.8p)、腹腔干淋巴结(No.9)转移的相对独立危险因素(P<0.01)。结论:淋巴管浸润、Ki-67LI增高、MMP-7及MMP-2阳性是胃癌胃左动脉淋巴结(No.7)、肝总动脉淋巴结(No.8a、No.8p)、腹腔干淋巴结(No.9)转移的相对独立危险因素。
OBJECTIVE: To investigate the relationship between abnormal expression of genes and clinicopathological factors in lymph node metastasis of left gastric artery (No.7), common hepatic artery (No.8a, No.8p) and celiac trunk (No.9). Methods: A retrospective study was performed to analyze the clinicopathological data of 70 patients with primary gastric cancer (single lesion) undergoing D2 and D3 radical resection. The expression of proliferating cell nuclear antigen (PCNA) in 70 primary gastric cancer tissues was detected by immunohistochemical staining. (LI), P53, C-erb B2, Survivin, MMP-2, MMP-7 and MMP-9 in gastric left ventricular lymph node (No.7 ), Hepatic artery lymph nodes (No.8a, No.8p), and celiac lymph node (No.9) metastasis. Results: Univariate analysis showed that the expression of Ki-67 LI, C-erb B2, MMP-7 and MMP-2 were significantly correlated with the size and depth of invasion, lymph node involvement and lymph node involvement , Hepatic artery lymph nodes (No.8a, No.8p) and celiac lymph node (No.9) (P <0.05). Multivariate analysis showed that lymphatic invasion, increased Ki-67 LI, and MMP-7 and MMP-2 positive were the gastric left gastric artery lymph nodes (No.7), common hepatic artery lymph nodes (No.8a, No.8p) Relatively independent risk factors for lymph node metastasis (No.9) (P <0.01). Conclusions: The lymphatic invasion and the increase of Ki-67LI are positive for MMP-7 and MMP-2 in gastric left gastric artery (No.7), hepatic artery (No.8a, No.8p) .9) Relative risk of metastasis.