论文部分内容阅读
目的研究转录因子e2f-1在胃癌发展过程中不同阶段的表达情况及其临床意义,判断其在胃癌发展中的作用。方法采用SABC免疫组化法检测121例胃癌原发灶中e2f-1的表达情况,分析其与临床病理特征和预后的关系。结果 121例患者e2f-1的表达阳性率为38.8%(47/121)。随着胃癌的进展,TNMⅠ～Ⅳ期e2f-1表达阳性率呈逐渐下降的趋势(r=-0.320,P<0.05):Ⅰa期62.5%(10/16),Ⅰb期47.1%(8/17),Ⅱ期55.0%(11/20),Ⅲa期40.0%(8/20),Ⅲb期27.3%(6/22),Ⅳ期15.4%(4/26);同时e2f-1的表达与肿瘤最大直径、浸润深度、淋巴结转移率和累及淋巴站亦呈负相关(P<0.05)。多参数检验分析显示组织学类型及生存期是e2f-1阳性表达的独立相关因素(P<0.05)。Log-Rank检验提示与术后生存相关的因素包括累及淋巴站、肿瘤最大直径、肿瘤位置、淋巴结转移率、浸润深度及TNM分期(P<0.05)。多因素Cox逐步回归分析提示累及淋巴站越远、e2f-1表达阳性率越高,则生存期越短(P<0.05)。TNM各期中:Ⅰ、Ⅱ期患者e2f-1的阳性高表达率与更短的生存期相关(r=-0.304,P<0.05),而且e2f-1呈阳性表达者其预后显著差于阴性表达者(χ2=13.437,P<0.05);而Ⅲ、Ⅳ期患者e2f-1的表达与生存期之间无统计学关系(P>0.05)。结论转录因子e2f-1是体现早期胃癌恶性行为的标记之一,表达阳性的早期患者生存时间显著缩短,是有效的预后判断因子;而在晚期胃癌中e2f-1表达降低,提示可能与其进展有关。
Objective To study the expression of e2f-1 in different stages of gastric cancer and its clinical significance to determine its role in the development of gastric cancer. Methods The expression of e2f-1 in 121 cases of primary gastric cancer was detected by SABC immunohistochemistry, and its relationship with clinicopathological features and prognosis was analyzed. Results The positive rate of e2f-1 expression in 121 patients was 38.8% (47/121). With the progression of gastric cancer, the positive rate of e2f-1 expression in TNM Ⅰ ~ Ⅳ gradually decreased (r = -0.320, P <0.05): 62.5% (10/16) in stage Ⅰa, 47.1% ), 55.0% (11/20) in stage Ⅱ, 40.0% (8/20) in stage Ⅲa, 27.3% (6/22) in stage Ⅲb and 15.4% (4/26) in stage Ⅳ. The expression of e2f- The maximum diameter, depth of invasion, lymph node metastasis and lymph node involvement were also negatively correlated (P <0.05). Multiparameter test analysis showed that histological type and survival were independent correlates of e2f-1 positive expression (P <0.05). Log-Rank test showed that postoperative survival related factors include lymph node involvement, maximum tumor diameter, tumor location, lymph node metastasis rate, depth of invasion and TNM stage (P <0.05). Multivariate Cox stepwise regression analysis showed that the longer the lymph node was involved, the higher the positive rate of e2f-1 expression was (P <0.05). The positive expression rates of e2f-1 in stage I and II were correlated with shorter survival time (r = -0.304, P <0.05), and the prognosis of patients with positive expression of e2f-1 was significantly lower than that of negative (Χ2 = 13.437, P <0.05). There was no significant correlation between the expression of e2f-1 and the survival in patients with stage Ⅲ, Ⅳ (P> 0.05). Conclusion Transcription factor e2f-1 is one of the markers of malignant behavior of early gastric cancer. The expression of e2f-1 is significantly reduced in the early stage of patients with gastric cancer, which is an effective prognostic factor. However, e2f-1 is downregulated in advanced gastric cancer, which may be related to its progression .