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目的探讨晚期胃癌组织中c-Met的表达与淋巴结转移度(lymph node ratio,LNR)及预后的关系。方法选取本院2005年9月至2010年9月行胃癌根治术并经病理检查确诊的晚期胃癌患者200例为研究对象。采用免疫组织化学法检测c-Met在胃癌组织中的表达水平;采用线性回归探讨c-Met表达与LNR及临床预后的关系;采用Cox回归模型探讨c-Met表达与肿瘤复发或转移的关系。结果200例患者中发生终点事件(复发、转移或死亡)78例,LNR4期患者发生终点事件的风险较高(约67.3%);c-Met表达水平与术前癌胚抗原(CEA)水平、肿瘤N分期、LNR呈正相关;LNR(P=0.013)、c-Met表达水平(P=0.020)、肿瘤侵犯深度(P=0.030)、肿瘤N分期(P=0.030)是晚期胃癌转移或复发的独立危险因素。结论高龄、恶性程度高的晚期胃癌发生复发、转移的风险明显增加,c-Met表达水平与LNR呈正相关,胃癌组织中高表达水平的c-Met是胃癌复发、转移的独立危险因素。
Objective To investigate the relationship between c-Met expression and lymph node ratio (LNR) and prognosis in advanced gastric cancer. Methods A total of 200 patients with advanced gastric cancer who underwent radical gastrectomy and confirmed by pathology from September 2005 to September 2010 in our hospital were selected as the study objects. The expression of c-Met in gastric cancer tissues was detected by immunohistochemistry. The relationship between c-Met expression and LNR and clinical prognosis was investigated by linear regression. The relationship between c-Met expression and tumor recurrence or metastasis was analyzed by Cox regression model. Results Seventy-eight patients with terminal events (recurrence, metastasis or death) occurred in 200 patients. The LN-stage 4 patients had a higher risk of end-point events (about 67.3%). The level of c-Met was correlated with preoperative carcinoembryonic antigen (CEA) (P = 0.013), the level of c-Met (P = 0.020), tumor invasion depth (P = 0.030) and tumor N stage (P = 0.030) were significantly correlated with LN staging and LN recurrence Independent risk factors. Conclusions There is a significant increase in the risk of recurrence and metastasis in advanced gastric cancer with advanced age and malignancy. The expression of c-Met is positively correlated with LNR. The high expression of c-Met in gastric cancer is an independent risk factor for gastric cancer recurrence and metastasis.