【摘要】：目的:探討癌旁正常組織、癌前病變組織及不同病理分期的胃癌組織中肝細(xì)胞再生磷酸酶-3(phosphatase of regenerating liver-3,PRL-3)及Rho C的表達(dá)差異及相關(guān)性,并進(jìn)一步分析兩者與胃癌浸潤、轉(zhuǎn)移及預(yù)后的關(guān)系。方法:收集右江民族醫(yī)學(xué)院附屬醫(yī)院2011年1月-2016年4月期間行胃癌根治術(shù)并且術(shù)后明確診斷為胃癌的患者80例,其中2011年1月-2012年10月間胃癌術(shù)后的患者60例,2015年9月-2016年4月間胃癌術(shù)后的患者20例。另外收集我院消化內(nèi)鏡室胃鏡下夾取的50例胃潰瘍患者的病變組織,經(jīng)病檢證實(shí)夾取的為高級別上皮內(nèi)瘤變的癌前病變組織。對照組為癌旁正常組織,病例組為胃癌組織和癌前病變組織。采用熒光定量Real-time PCR和免疫組化技術(shù)檢測癌前病變組、胃癌組及其對應(yīng)的癌旁組中PRL-3及RhoC的mRNA和蛋白表達(dá)情況。結(jié)合臨床病理及隨訪資料,分析兩者的表達(dá)與患者預(yù)后的關(guān)系。結(jié)果:(1)PRL-3的mRNA在胃癌組的相對表達(dá)量為(3.45±1.21),高于其對應(yīng)的癌旁組的表達(dá)(0.84±0.12)及其在癌前病變組的表達(dá)(1.42±0.65)(均P0.05);RhoC的mRNA在胃癌組的相對表達(dá)量為(3.62±1.35),高于其對應(yīng)的癌旁組的表達(dá)(0.87±0.18)及其在癌前病變組的表達(dá)(1.51±0.83)(均P0.05)。(2)PRL-3的蛋白在胃癌組的陽性表達(dá)率為75%,高于其在癌旁組的陽性表達(dá)率25%及在癌前病變組的陽性表達(dá)率58%;胃癌組中RhoC的蛋白陽性表達(dá)率為77.5%,高于其在癌旁組的陽性表達(dá)率21.25%及癌前病變組的陽性表達(dá)率40%(均P0.05)。(3)PRL-3與RhoC在胃癌組織中的基因和蛋白表達(dá)水平與胃癌患者的分化程度、浸潤深度、TNM分期及淋巴結(jié)轉(zhuǎn)移密切相關(guān)(均P0.05),且兩者的表達(dá)呈正相關(guān)(PRL-3:rs=0.726,P0.05;RhoC:rs=0.740,P0.05)。(4)Kaplan-Meier生存曲線分析及Log-rank檢驗(yàn)顯示,PRL-3與RhoC陰性表達(dá)組的生存率明顯高于兩者陽性表達(dá)組患者的生存率(PRL-3:P=0.032;RhoC:P=0.014)。結(jié)論:(1)PRL-3與RhoC的mRNA和蛋白在胃癌組織中高表達(dá),與胃癌的侵襲和轉(zhuǎn)移密切相關(guān),并且兩者的表達(dá)呈正相關(guān)性,表明兩者對胃癌的發(fā)生發(fā)展起著重要的作用。(2)從正常胃粘膜病變?yōu)榘┣安∽兘M織,最終發(fā)展為胃癌,這一過程中PRL-3與RhoC的基因和蛋白表達(dá)水平呈遞增趨勢,因此聯(lián)合檢測兩者的表達(dá)情況有助于提高早癌診斷率,兩者有望成為胃癌早期診斷的標(biāo)記物。(3)PRL-3與RhoC的蛋白表達(dá)與胃癌患者的預(yù)后緊密相關(guān),PRL-3與RhoC陽性表達(dá)組患者的年生存率明顯低于陰性表達(dá)組,因此兩者可作為評估胃癌預(yù)后有意義的風(fēng)險(xiǎn)因素。
[Abstract]:Objective: to investigate the expression of hepatocyte regenerative phosphatase -3 (phosphatase of regenerating liver-3 PRL-3 and Rho C in adjacent normal tissues, precancerous lesions and gastric cancer tissues with different pathological stages, and to further analyze the relationship between them and the invasion of gastric cancer. The relationship between metastasis and prognosis. Methods: from January 2011 to April 2016, 80 patients with gastric cancer were treated with radical gastrectomy and diagnosed as gastric cancer after operation in affiliated Hospital of Youjiang Medical College for nationalities. From January 2011 to October 2012, there were 60 patients with gastric cancer and 20 patients with gastric cancer from September 2015 to April 2016. In addition, the pathological tissues of 50 patients with gastric ulcer were collected by endoscopy and gastroscopy in our hospital. The precancerous lesions of high grade intraepithelial neoplasia were confirmed by pathological examination. The control group was adjacent normal tissue, the case group was gastric cancer tissue and precancerous lesion tissue. The expression of mRNA and protein of PRL-3 and RhoC in precancerous lesion group, gastric cancer group and its corresponding paracancerous group were detected by fluorescence quantitative Real-time PCR and immunohistochemistry. Combined with clinicopathological and follow-up data, the relationship between the expression and prognosis of patients was analyzed. Results: (1) the relative expression of PRL-3 mRNA in gastric cancer group was (3.45 鹵1.21), higher than that in corresponding paracancerous group (0.84 鹵0.12) and in precancerous lesion group (1.42 鹵0.65) (P0.05). (0.87 鹵0.18) and its expression in precancerous lesion group (1.51 鹵0.83) (P0.05, P0.05) the positive rate of PRL-3 expression in gastric cancer group was 75. 5%, which was higher than that in paracancerous group (25%) and in precancerous lesion group (58%), and the positive expression rate of RhoC protein in gastric cancer group was 58%. The positive expression rate of PRL-3 and RhoC in gastric cancer tissue was higher than that in paracancerous group (21.25%) and precancerous lesion group (40%) (P0.05). (3). TNM stage and lymph node metastasis were closely correlated with the depth of invasion (P0.05), and there was a positive correlation between them (PRL-3: Rs0. 726 P0. 05). (4). Kaplan-Meier survival curve analysis and Log-rank test showed that the survival rate of PRL-3 and RhoC negative expression group was significantly higher than that of PRL-3P0. 032 RhoC: P0. 014 group. Conclusion: (1) the high expression of mRNA and protein of PRL-3 and RhoC in gastric carcinoma is closely related to the invasion and metastasis of gastric cancer, and the expression of mRNA and protein is positively correlated. These results indicate that both of them play an important role in the development of gastric cancer. (2) the expression of PRL-3 and RhoC genes and proteins in gastric cancer is increasing from normal gastric mucosal lesions to precancerous lesions and eventually to gastric cancer. Therefore, combined detection of the expression of both is helpful to improve the diagnostic rate of early cancer. (3) the protein expression of PRL-3 and RhoC was closely related to the prognosis of gastric cancer patients. The annual survival rate of patients with positive expression of PRL-3 and RhoC was significantly lower than that of patients with negative expression. Therefore, both can be used as a significant risk factor for evaluating the prognosis of gastric cancer.
【學(xué)位授予單位】：右江民族醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.2

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