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背景与目的:胃癌复发转移是术后化疗失败的主要原因,本文试图通过观察胃癌组织中EGFR、IL-6R、PCNA的表达、DNA指数(DI)及DNA倍体,并寻找它们在胃癌复发转移者组织中的分布规律,从而为判定胃癌是否有术前转移及术后复发提供可靠的依据。方法:应用免疫组织化学SP法及图像分析仪Fegulgen染色对199例胃癌、20例正常胃粘膜、20例不典型增生中的EGFR、IL-6R、PCNA、DI及DNA倍体进行检测。结果:有淋巴结及远处转移、残胃癌的癌组织中EGFR表达水平(阳性率分别为61.11%、66%、66.67%)较其它癌组织、正常胃粘膜、不典型增生(阳性率分别为47.83%、0%、35%)高(P<0.01);DNA倍体分布形式上,有转移胃癌、残胃癌的癌组织中非整倍体细胞百分率(56.9±13.3)%明显高于其它(无转移胃癌为(12.8±6.3)%,正常胃粘膜及不典型增生为0%,早期胃癌为11.2%),它们之间相比有显著性差异(P<0.01);DNA指数亦高(有转移胃癌及残胃癌DNA指数为2.91±0.33,无转移胃癌DNA指数为2.17±0.29,二者相比有显著差异P<0.01),但2C细胞检出率低(无转移胃癌为43.8±12.9,有转移胃癌及残胃癌为10.2±7.5,二者相比有显著差异P<0.01)。结论:EGFR、DI及DNA倍体可作为胃癌术前判断是否有复发、转移危险性的指标。
BACKGROUND & OBJECTIVE: Gastric cancer recurrence and metastasis is the main reason of postoperative chemotherapy failure. This paper attempts to observe the expression of EGFR, IL-6R and PCNA, DNA index (DI) and DNA ploidy in gastric cancer tissues and to find out their roles in recurrence and metastasis of gastric cancer The organization of the distribution of law, so as to determine whether there is a preoperative gastric cancer metastasis and postoperative recurrence provide a reliable basis. Methods: EGFR, IL-6R, PCNA, DI and DNA ploidy in 199 cases of gastric cancer, 20 cases of normal gastric mucosa and 20 cases of atypical hyperplasia were detected by immunohistochemical SP method and image analyzer Fegulgen staining. Results: Compared with other cancerous tissues, normal gastric mucosa, and atypical hyperplasia, the positive rate of EGFR expression in cancer tissues with lymph node metastasis and remnant gastric cancer was 61.11%, 66%, 66.67% respectively (the positive rates were 47.83 %, 0%, 35%) (P <0.01). DNA ploidy distribution: The percentage of aneuploid cells (56.9 ± 13.3)% in gastric cancer tissues and gastric stump cancer tissues was significantly higher than that in others Metastasis of gastric cancer was (12.8 ± 6.3)%, normal gastric mucosa and dysplasia was 0%, early gastric cancer was 11.2%), there was a significant difference between them (P <0.01); DNA index was also high The DNA index of gastric cancer and gastric stump cancer was 2.91 ± 0.33, the DNA index of non-metastatic gastric cancer was 2.17 ± 0.29, there was a significant difference between them (P <0.01), but the detection rate of 2C cells was low (43.8 ± 12.9 without metastasis gastric cancer Metastatic gastric cancer and residual gastric cancer was 10.2 ± 7.5, there was a significant difference between the two P <0.01). Conclusion: EGFR, DI and DNA ploidy can be used as indicators of the risk of recurrence and metastasis of gastric cancer before surgery.