RRM1、CDX2在不同胃黏膜中的表达及临床意义

Clinical significance of RRM1, CDX2 expression in different gastric mucosa lesions

关键词:  胃肿瘤  诊断  RRM1、CDX2  免疫组织化学

Key words:  gastric carcinoma  diagnosis  RRM1  CDX2  Immunohistochemisty

摘要:

目的　探讨核苷酸还原酶亚单位 M1(ribonucleotide reductase M1，RRM1）、尾型同源盒转录因子2（caudal-related homeobox transcription factor 2,CDX2）在不同胃黏膜组织中的表达，并分析其与胃癌发生发展及预后的关系。方法　选取中国人民解放军第一七五医院病理科保存的组织蜡快240例，其中胃癌90例、高级别上皮内瘤变30例、低级别上皮内瘤变30例、肠上皮化生30例、浅表性胃炎30例、正常胃黏膜30例，采用S-P免疫组化方法检测6类不同胃黏膜组织RRM1、CDX2表达，进行临床病理相关性分析。结果　正常胃黏膜、浅表性胃炎、肠上皮化生、低级别上皮内瘤变、高级别上皮内瘤变和胃癌中RRM1的阳性表达分别为40.0%、66.7%、33.3%、83.3%、83.3%、86.7%，胃癌、高级别上皮内瘤变、低级别上皮内瘤变组RRM1的阳性表达率均显著高于正常胃黏膜组与肠上皮化生组（P<0.01)，亦高于浅表性胃炎组（P<0.05）。CDX1的阳性表达分别为16.7%、0%、63.3%、33.3%、76.7%、61.1%,高级别上皮内瘤变、肠上皮化生、胃癌组的CDX2阳性表达率均显著高于浅表性胃炎组与正常胃黏膜组（P<0.01),高于低级别上皮内瘤变组（P<0.05）。240例不同胃黏膜病变中，RRM1与CDX2之间表达呈正相关（r_s=0.196，P=0.002)，90例胃癌中RRM1与CDX2之间呈正相关关系（r_s=0.223，P=0.034)；RRM1、CDX2表达与分化程度密切相关(P<0.05)，CDX2表达与浸润深度、淋巴结转移、TNM分期密切相关(P<0.05)。结论　RRM1、CDX2表达均与胃癌的发生发展及预后有关，均可作为较为理想的肿瘤标志物，用于胃癌的早期诊断和转移的预警。

Abstract:

Objective 　 To explore the expression of ribonucleotide reductase M1(RRM1)and caudal-related homeobox transcription factor 2(CDX2) in different gastric mucosa lesions and evaluate its relationship with the occurrence, development and prognosis of gastric cancer.　Methods 　 A total of 240 cases were selected from Department of Pathology of 175th Hospital of PLA, including 90 cases of gastric cancer,30 cases of high-grade intraepithelial neoplasia,30 cases of low-grade intraepithelial neoplasia,30 cases of intestinal metaplasia, 30 cases of superficial gastritis, 30 cases of normal gastric mucosa. Expression of RRM1 and CDX2 was detected with immunohistochemistry SP method.　Results The frequency of RRM1 expression were 86.7%,83.3% and 83.3% in gastric cancer group, high-grade intraepithelial neoplasia group and low-grade intraepithelial neoplasia group,respectively. The frequencies were all higher than that in superficial gastritis group (66.7%,P<0.05) and that in intestinal metaplasia group (33.3%,P<0.01).The frequency of RRM1 expression was higher in superficial gastritis group than that in intestinal metaplasia group(P<0.05). The frequency of CDX2 expression were 76.7%,63.3% and 61.1% in high-grade intraepithelial neoplasia group, intestinal metaplasia group and gastric cancer group,respectively. The frequencies were all higher than that in low-grade intraepithelial neoplasia group(33.3%,P<0.05) and that in superficial gastritis group (0%,P<0.01). In 240 cases of different gastric mucosa lesions, RRM1 expression was positively correlated with CDX2 expression（r_s=0.196, P=0.002). In 90 cases of gastric cancer, RRM1 expression was positively correlated with CDX2（r_s=0.223, P=0.034).The expression of RRM1 and CDX2 were related with the differentiation degree (P<0.05). CDX2 expression was related with the tumor invasion depth, TNM stages and the lymph node metastasis (P<0.05). 　Conclusions 　 The expression of RRM1 and CDX2 could be used as tumor marker_sfor early diagnosis and indicating metastasis of gastric cancer.