中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2009年
24期
2197-2199,2203
,共4页
冯丽英%秦玉彩%尹希%马丽
馮麗英%秦玉綵%尹希%馬麗
풍려영%진옥채%윤희%마려
胃肿瘤%癌前状态%三叶因子家族
胃腫瘤%癌前狀態%三葉因子傢族
위종류%암전상태%삼협인자가족
Stomach neoplasms%Precancerous conditions%Trefoil factor family
目的 探讨三叶因子家族(TFF)在胃癌及癌前病变中的表达及其意义.方法 选择经胃镜活检并经病理证实的基本正常或轻度浅表性胃炎患者20例(正常胃黏膜组)、慢性浅表性胃炎伴胃黏膜肠上皮化生患者30例(肠上皮化生组)、慢性萎缩性胃炎伴胃黏膜不典型增生患者24例(不典型增生组)和胃癌患者40例(胃癌组).采用免疫组化s-p法检测上述受检者的手术标本中TFF1、TFF2和TFF3的表达情况,并分析TFF与胃癌组织学类型、分化程度、浆膜浸润、淋巴结转移及TNM分期等临床病理特征的关系.结果 TFF1、TFF2在正常胃黏膜、不典型增生胃黏膜、肠上皮化生胃黏膜及胃癌组织中均有表达,二者表达强度依次呈递减趋势(P<0.05);TFF3在正常胃黏膜没有表达,而在肠上皮化生胃黏膜、不典型增生胃黏膜和胃癌组织中均有表达,表达强度依次呈递增趋势(P<O.05).在胃癌组织中,TFF1在低分化胃癌中的表达阳性率显著高于中高分化胃癌(73.7%与38.1%,P<0.05),而TFF2在中高分化胃癌中的表达阳性率显著高于低分化胃癌(90.5%与47.4%,P<0.01),二者均与胃癌是否发生浆膜浸润、是否有淋巴结转移及TNM分期无关(P>0.05);TFF3在有浆膜浸润、伴淋巴结转移和分期较晚(Ⅲ/Ⅳ期)胃癌组织中的表达阳性率[分别为91.7%、88.9%和95.O%]显著高于无浆膜浸润及淋巴结转移和I/Ⅱ期的胃癌组织(37.5%、46.2%和55.O%,P<0.01),但与胃癌组织的分化程度无关(P>0.05);TFF1、TFF2和TFF3在弥漫型胃癌组织中的表达阳性率[分别为75.0%、82.1%和85.7%]显著高于肠型胃癌组织[分别为25.O%、41.7%和50.O%],差异有统计学意义(P<O.05).结论 TFF1和TFF2在正常胃黏膜-肠上皮化生-不典型增生-胃癌组织中的表达逐渐减少以及TFF3的表达逐渐增多可能在胃癌发生中起重要作用.TFF1和TFF2可能是胃癌抑制因子,其表达减少可能使胃癌恶性程度增加;TFF3可能与胃癌浸润转移有关,其表达增多则预后不良.
目的 探討三葉因子傢族(TFF)在胃癌及癌前病變中的錶達及其意義.方法 選擇經胃鏡活檢併經病理證實的基本正常或輕度淺錶性胃炎患者20例(正常胃黏膜組)、慢性淺錶性胃炎伴胃黏膜腸上皮化生患者30例(腸上皮化生組)、慢性萎縮性胃炎伴胃黏膜不典型增生患者24例(不典型增生組)和胃癌患者40例(胃癌組).採用免疫組化s-p法檢測上述受檢者的手術標本中TFF1、TFF2和TFF3的錶達情況,併分析TFF與胃癌組織學類型、分化程度、漿膜浸潤、淋巴結轉移及TNM分期等臨床病理特徵的關繫.結果 TFF1、TFF2在正常胃黏膜、不典型增生胃黏膜、腸上皮化生胃黏膜及胃癌組織中均有錶達,二者錶達彊度依次呈遞減趨勢(P<0.05);TFF3在正常胃黏膜沒有錶達,而在腸上皮化生胃黏膜、不典型增生胃黏膜和胃癌組織中均有錶達,錶達彊度依次呈遞增趨勢(P<O.05).在胃癌組織中,TFF1在低分化胃癌中的錶達暘性率顯著高于中高分化胃癌(73.7%與38.1%,P<0.05),而TFF2在中高分化胃癌中的錶達暘性率顯著高于低分化胃癌(90.5%與47.4%,P<0.01),二者均與胃癌是否髮生漿膜浸潤、是否有淋巴結轉移及TNM分期無關(P>0.05);TFF3在有漿膜浸潤、伴淋巴結轉移和分期較晚(Ⅲ/Ⅳ期)胃癌組織中的錶達暘性率[分彆為91.7%、88.9%和95.O%]顯著高于無漿膜浸潤及淋巴結轉移和I/Ⅱ期的胃癌組織(37.5%、46.2%和55.O%,P<0.01),但與胃癌組織的分化程度無關(P>0.05);TFF1、TFF2和TFF3在瀰漫型胃癌組織中的錶達暘性率[分彆為75.0%、82.1%和85.7%]顯著高于腸型胃癌組織[分彆為25.O%、41.7%和50.O%],差異有統計學意義(P<O.05).結論 TFF1和TFF2在正常胃黏膜-腸上皮化生-不典型增生-胃癌組織中的錶達逐漸減少以及TFF3的錶達逐漸增多可能在胃癌髮生中起重要作用.TFF1和TFF2可能是胃癌抑製因子,其錶達減少可能使胃癌噁性程度增加;TFF3可能與胃癌浸潤轉移有關,其錶達增多則預後不良.
목적 탐토삼협인자가족(TFF)재위암급암전병변중적표체급기의의.방법 선택경위경활검병경병리증실적기본정상혹경도천표성위염환자20례(정상위점막조)、만성천표성위염반위점막장상피화생환자30례(장상피화생조)、만성위축성위염반위점막불전형증생환자24례(불전형증생조)화위암환자40례(위암조).채용면역조화s-p법검측상술수검자적수술표본중TFF1、TFF2화TFF3적표체정황,병분석TFF여위암조직학류형、분화정도、장막침윤、림파결전이급TNM분기등림상병리특정적관계.결과 TFF1、TFF2재정상위점막、불전형증생위점막、장상피화생위점막급위암조직중균유표체,이자표체강도의차정체감추세(P<0.05);TFF3재정상위점막몰유표체,이재장상피화생위점막、불전형증생위점막화위암조직중균유표체,표체강도의차정체증추세(P<O.05).재위암조직중,TFF1재저분화위암중적표체양성솔현저고우중고분화위암(73.7%여38.1%,P<0.05),이TFF2재중고분화위암중적표체양성솔현저고우저분화위암(90.5%여47.4%,P<0.01),이자균여위암시부발생장막침윤、시부유림파결전이급TNM분기무관(P>0.05);TFF3재유장막침윤、반림파결전이화분기교만(Ⅲ/Ⅳ기)위암조직중적표체양성솔[분별위91.7%、88.9%화95.O%]현저고우무장막침윤급림파결전이화I/Ⅱ기적위암조직(37.5%、46.2%화55.O%,P<0.01),단여위암조직적분화정도무관(P>0.05);TFF1、TFF2화TFF3재미만형위암조직중적표체양성솔[분별위75.0%、82.1%화85.7%]현저고우장형위암조직[분별위25.O%、41.7%화50.O%],차이유통계학의의(P<O.05).결론 TFF1화TFF2재정상위점막-장상피화생-불전형증생-위암조직중적표체축점감소이급TFF3적표체축점증다가능재위암발생중기중요작용.TFF1화TFF2가능시위암억제인자,기표체감소가능사위암악성정도증가;TFF3가능여위암침윤전이유관,기표체증다칙예후불량.
Objective To explore the expression and significance of trefoil factor 1 (TFF1) , TFF2 and TFF3 in pre-cancerous condition and gastric cancer. Methods TFF expression was determined by immunohistochemistry in paraffin - embedded samples from the patients including normal gastric mucosa ( 20 specimens) , intestinal metaplasia in gastritic mucosa (30 specimens), displastic gastritic micosa (24 specimens) and gastric cancer (40 specimens). To study the relationship the rela-tionship between TFF and gastric cancer tissues histologic type, differentiation of the tumor, depth of invasion, lymph node me-tastases and pathological stages (International union control cancer public TNM stages). Results TFF1, TFF2 and TFF3 were measured in the normal gastric mucosa, intestinal mataplasia, displasic gastric mucosa and gastric cancer, the level of TFF1 and TFF2 expression had a decreased tendency (P<0.05). TFF3 was absent in normal gastric mucosa, but measured in intestinal mataplasia, displasic gastric mucosa and gastric carcinomas, and the level of that expression had a increasing tendency (P < 0. 05). The positive rates of TFF1 expression in poorly differentiated gastric cancer were higher than those in moderately/well dif-ferentiated type (73.7% vs 38. 1% , P <0. 05) ; the TFF2 expression was predominately in well differentiated type, higher than those in poorly differentiated type (90. 5% vs 47.4% , P <0. 01) ; TFF1 and TFF2 was no correlation to gastric cancer se-rosal invasion, lymph node metastasis and TNM classification (P >0. 05). The positive rate of TFF3 in gastric cancers serosal invasion, lymph node metastasis and at stage Ⅲ/Ⅳ (91. 7% , 88. 9% and 95. 0% ) significantly higher than those without sero-sal invasion and lymph node metastasis and stage Ⅰ /Ⅱ (37. 5% , 46. 2% and 55. 0% , P <0. 01, respectively) , but it was no correlation to gastric cancer differentiated type ( P > 0. 05 ). The expression rate of TFF1, TFF2 and TFF3 in diffuse type (75. 0% , 82. 1% and 85. 7% ) were significantly higher than those intestinal type tumors (25. 0% , 41. 7% and 50. 0% , P < 0. 05, respectively). Conclusion Progressive loss of TFF1 and TFF2, together with the increase of TFF3 is likely to be in-volved in the gastric cancer. TFF1 and TFF2 probable depress gastric cancer, and might be a tumor suppressor factors. TFF3 that might play a role in the course of tumor invasion and metastasis. The patients with TFF3 positive gastric cancers may be poor prognosis.
