中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
23期
2726-2730
,共5页
赵爽%郑华川%赵恩宏%郑鑫%肖丽君%高野康雄
趙爽%鄭華川%趙恩宏%鄭鑫%肖麗君%高野康雄
조상%정화천%조은굉%정흠%초려군%고야강웅
胃肠肿瘤%Parafibromin蛋白%病理特征%预后
胃腸腫瘤%Parafibromin蛋白%病理特徵%預後
위장종류%Parafibromin단백%병리특정%예후
Gastrointestinal neoplasms%Parafibromin protein%Pathological features%Prognosis
目的:检测胃肠道癌组织中Parafibromin蛋白的表达,并探讨其与临床病理特征和预后的关系。方法选取1997年12月-2008年12月日本富山大学医学部手术切除并经病理证实为胃肠道癌的患者814例。收集所有胃肠道癌患者癌组织标本814份,同时收集胃肠道癌患者癌旁组织标本328份及腺瘤组织标本129份。采用免疫组织化学法检测胃肠道癌组织、癌旁组织和腺瘤组织中Parafibromin蛋白的表达情况;并对胃肠道癌患者进行生存分析和死亡危险因素的Cox回归分析。结果 Parafibromin蛋白表达阳性率在胃肠道癌组织中为48.9%(398/814),低于腺瘤组织及癌旁组织的78.3%(101/129)和92.7%(304/328),差异有统计学意义(χ2=189.20、47.50,P<0.05)。Spearman等级相关分析显示,Parafibromin 蛋白表达阳性与肿瘤直径、淋巴管侵袭、淋巴结转移、UICC 分期呈负相关( rs=-0.198、-0.134、-0.238、-0.244,P <0.05),与性别、年龄、静脉侵袭无相关性( rs =0.055、0.039、-0.048,P>0.05)。电话随访573例胃肠道癌患者,失访241例,生存时间为0.2~146.4个月,平均42.1个月。生存分析显示,Parafibromin蛋白表达阴性患者累积生存率低于Parafibromin蛋白表达阳性患者(χ2=32.60,P<0.05)。Cox回归分析显示,年龄≥60岁〔OR(95%CI)=1.589(1.194,2.113)〕、肿瘤直径≥4.5 cm〔OR(95%CI)=1.407(1.037,1.908)〕、有淋巴管侵袭〔OR(95%CI)=1.925(1.445,2.565)〕、有淋巴结转移〔OR(95%CI)=2.621(1.867,3.679)〕、UICC分期Ⅲ~Ⅳ期〔OR(95%CI)=1.564(1.067,2.292)〕是胃肠道癌死亡的独立危险因素(P<0.05),而Parafibromin蛋白表达阳性〔OR(95%CI)=0.611(0.463,0.806)〕是胃肠道癌死亡的保护因素(P<0.05)。结论 Parafibromin蛋白表达降低与胃肠道癌的发生、侵袭和转移有关,且与胃肠道癌患者的预后密切相关,Parafibromin蛋白可作为潜在的胃肠道癌预后指标,为今后的临床研究提供参考价值。
目的:檢測胃腸道癌組織中Parafibromin蛋白的錶達,併探討其與臨床病理特徵和預後的關繫。方法選取1997年12月-2008年12月日本富山大學醫學部手術切除併經病理證實為胃腸道癌的患者814例。收集所有胃腸道癌患者癌組織標本814份,同時收集胃腸道癌患者癌徬組織標本328份及腺瘤組織標本129份。採用免疫組織化學法檢測胃腸道癌組織、癌徬組織和腺瘤組織中Parafibromin蛋白的錶達情況;併對胃腸道癌患者進行生存分析和死亡危險因素的Cox迴歸分析。結果 Parafibromin蛋白錶達暘性率在胃腸道癌組織中為48.9%(398/814),低于腺瘤組織及癌徬組織的78.3%(101/129)和92.7%(304/328),差異有統計學意義(χ2=189.20、47.50,P<0.05)。Spearman等級相關分析顯示,Parafibromin 蛋白錶達暘性與腫瘤直徑、淋巴管侵襲、淋巴結轉移、UICC 分期呈負相關( rs=-0.198、-0.134、-0.238、-0.244,P <0.05),與性彆、年齡、靜脈侵襲無相關性( rs =0.055、0.039、-0.048,P>0.05)。電話隨訪573例胃腸道癌患者,失訪241例,生存時間為0.2~146.4箇月,平均42.1箇月。生存分析顯示,Parafibromin蛋白錶達陰性患者纍積生存率低于Parafibromin蛋白錶達暘性患者(χ2=32.60,P<0.05)。Cox迴歸分析顯示,年齡≥60歲〔OR(95%CI)=1.589(1.194,2.113)〕、腫瘤直徑≥4.5 cm〔OR(95%CI)=1.407(1.037,1.908)〕、有淋巴管侵襲〔OR(95%CI)=1.925(1.445,2.565)〕、有淋巴結轉移〔OR(95%CI)=2.621(1.867,3.679)〕、UICC分期Ⅲ~Ⅳ期〔OR(95%CI)=1.564(1.067,2.292)〕是胃腸道癌死亡的獨立危險因素(P<0.05),而Parafibromin蛋白錶達暘性〔OR(95%CI)=0.611(0.463,0.806)〕是胃腸道癌死亡的保護因素(P<0.05)。結論 Parafibromin蛋白錶達降低與胃腸道癌的髮生、侵襲和轉移有關,且與胃腸道癌患者的預後密切相關,Parafibromin蛋白可作為潛在的胃腸道癌預後指標,為今後的臨床研究提供參攷價值。
목적:검측위장도암조직중Parafibromin단백적표체,병탐토기여림상병리특정화예후적관계。방법선취1997년12월-2008년12월일본부산대학의학부수술절제병경병리증실위위장도암적환자814례。수집소유위장도암환자암조직표본814빈,동시수집위장도암환자암방조직표본328빈급선류조직표본129빈。채용면역조직화학법검측위장도암조직、암방조직화선류조직중Parafibromin단백적표체정황;병대위장도암환자진행생존분석화사망위험인소적Cox회귀분석。결과 Parafibromin단백표체양성솔재위장도암조직중위48.9%(398/814),저우선류조직급암방조직적78.3%(101/129)화92.7%(304/328),차이유통계학의의(χ2=189.20、47.50,P<0.05)。Spearman등급상관분석현시,Parafibromin 단백표체양성여종류직경、림파관침습、림파결전이、UICC 분기정부상관( rs=-0.198、-0.134、-0.238、-0.244,P <0.05),여성별、년령、정맥침습무상관성( rs =0.055、0.039、-0.048,P>0.05)。전화수방573례위장도암환자,실방241례,생존시간위0.2~146.4개월,평균42.1개월。생존분석현시,Parafibromin단백표체음성환자루적생존솔저우Parafibromin단백표체양성환자(χ2=32.60,P<0.05)。Cox회귀분석현시,년령≥60세〔OR(95%CI)=1.589(1.194,2.113)〕、종류직경≥4.5 cm〔OR(95%CI)=1.407(1.037,1.908)〕、유림파관침습〔OR(95%CI)=1.925(1.445,2.565)〕、유림파결전이〔OR(95%CI)=2.621(1.867,3.679)〕、UICC분기Ⅲ~Ⅳ기〔OR(95%CI)=1.564(1.067,2.292)〕시위장도암사망적독립위험인소(P<0.05),이Parafibromin단백표체양성〔OR(95%CI)=0.611(0.463,0.806)〕시위장도암사망적보호인소(P<0.05)。결론 Parafibromin단백표체강저여위장도암적발생、침습화전이유관,차여위장도암환자적예후밀절상관,Parafibromin단백가작위잠재적위장도암예후지표,위금후적림상연구제공삼고개치。
Objective To clarify the roles of parafibromin expression and the correlation with aggressive features and prognosis of gastrointesitnal carcinomas. Methods From December 1997 to December 2008 selected 814 Patients with gastroin-testinal cancer in Japan Toyama University Faculty of Medicine. It was examined by immunohistochemistry on tissue microarray containing gastrointestinal carcinomas(n=814),adenomas(n=129)and non-neoplastic mucosa(n=328)with a compari-son of its expression with clinicopathological parameters,and conducted survival analysis and risk factors for death Cox regression analysis. ResUlts Parafibromin expression was localized in the nucleus of gastrointesitnal epithelial cells,adenoma and carcino-ma cells. Its expression was gradually decreased from non-neoplastic mucosa to carcinoma,through adenomas(χ2 =189. 20, 47. 50;P<0. 05)and negative correlation with tumour size,lymphatic invasion,lymph node metastasis and Union Internation-ale Contrele Cancer(UICC)staging(rs = -0. 198,-0. 134,-0. 238,-0. 244;P<0. 05),but not with sex,age or ve-nous invasion(rs =0. 055,0. 039,-0. 048;P >0. 05). Telephone follow -up of 573 cases of gastrointestinal cancer pa-tients,lost 241 cases,survival time was 0. 2 to 146. 4 months,an average of 42. 1 months. Survival analysis showed cumulative survival rate of patients with positive Parafibromin expression to be higher than without its expression(χ2 =32. 60,P<0. 05). Cox regression analysis showed that age≥60 years〔OR(95%CI) =1. 589(1. 194,2. 113)〕,tumor size≥4. 5 cm〔OR (95%CI) =1. 407(1. 037,1. 908)〕,lymphatic invasion〔OR(95%CI) =1. 925(1. 445,2. 565)〕,lymph node me-tastasis〔OR(95%CI) =2. 621(1. 867,3. 679)〕,UICC staging Ⅲ to Ⅳ〔OR(95%CI) =1. 564(1. 067,2. 292)〕venous invasion were independent prognostic factors for carcinomas(P<0. 05). Positive expression of Parafibromin protein in〔OR(95%CI) =0. 611(0. 463,0. 806)〕were protective factors of death of gastrointestinal cancer(P<0. 05). ConclU-sion Down-regulated Parafibromin expression possibly contributes to pathogenesis,growth,invasion and metastasis of gastro-intestinal and might be considered as a promising marker to indicate the aggressive behaviors and prognosis of gastrointesitnal car-cinomas.