中国临床肿瘤学教育专辑 (2007) 341

    大规模胃癌组织芯片的构建以及胃癌预后因素的分析

    上海市长征医院肿瘤科 王杰军 于观贞 陈 颖 王 喜 潘 军

    摘要 目的：探寻组织芯片在胃癌研究中的意义，并初步研究影响预后的临床病理因素。方

    法：收集 1072 例胃癌手术切除标本，利用组织芯片仪构建组织芯片，结合免疫组化，检测 P53

    和 PCNA 的表达。并用 Kaplan-Meier 分析和多因素 Cox 回归等统计方法分析影响胃癌患者预后

    的相关因素。结果：成功构建了含有 1072 例胃癌信息的组织芯片，P53 和 PCNA 在胃癌中的表

    达率显著高于正常组织中的表达，分别为55.1%和 89.3%，进展期胃癌中的表达率显著高于早期

    胃癌中的表达。P53的过度表达与年龄、男性、贫血、腺癌、分化、浆膜侵犯和淋巴结转移高度

    相关；而 PCNA则与年龄、肿瘤部位、腺癌、分化、浆膜侵犯、淋巴结转移以及TNM高度相关。

    单因素分析当中，年龄、贫血、肿瘤大小、分化、肿瘤分期、侵犯深度、淋巴结转移、手术方式、切缘、术中输血以及 PCNA 均与患者恶性预后相关。而在 Cox 回归多因素分析当中，年龄、分

    化、肿瘤分期、淋巴结转移、手术方式、术中输血以及PCNA与患者恶性预后相关。结论：P53

    和 PCNA 在胃癌的发生和发展的过程中起到重要作用；患者、肿瘤、手术情况和生物学因素在

    内的综合因素影响了胃癌患者的预后。

    The Construction of Tissue Microarrays of Gastric Carcinoma And Analysis of

    Clinicopathological Prognostic Factors of Chinese Gastric Cancer Patietns

    WANG Jie-Jun*, YU Guan-Zhen, CHEN Ying,. 1.Department of Oncology, Chang-zheng Hospital,Shanghai 200070, China; 2. Department of Pathology, Chang-hai Hospital, Shanghai 200433, China

    Abstract Objective: To construct tissue microarrays of human gastric carcinoma containing large

    proportion of cases and to investigate prognostic factors of gastric carcinoma. METHODS: Clinical

    data of 1072 patients with gastric carcinoma, received radical operation from Jan. 2001 to May. 2005

    were used to construct the tissue microarrays and analyzed retrospectively. Life table method was used

    to analyze survival rate, Kaplan-Meier was used for univariate analysis, and Cox regression model was

    used for multivariate analysis. Immunohistochemistry was used to detect the expression of p53 and

    PCNA. RESULTS: Tissue microarrays containing 1072 cases were successfully constructed. P53 and

    PCNA was overexpressed in the primary tumor, 55.1% and 89.3%， respectively. Overexpression of P53

    was significantly associated with age, male, anemia, tumor type, differentiation, gastric wall invasion,nodal metastasis and TNM stage. PCNA overexpression had a significant relationship with age, tumor

    type, tumor location, differentiation, gastric wall invasion, nodal metastasis and TNM stage. Univariate

    analysis showed that age, anemia, tumor size, tumor stage, invasion, nodal metastasis, surgical methods,tumor margin, blood transfusion and PCNA were prognostic factors of gastric carcinoma. Multivariate

    analysis showed that age, differentiation, pTNM stage, nodal metastasis, surgical methods, blood

    transfusion and PCNA were independent prognostic factors of gastric carcinoma. CONCLUSIONS:

    Tissue microarrays provide a useful platform for the scientific research of gastric cancer. P53 and

    PCNA play a critical role in the development and progress of gastric carcinoma. Age, differentiation,pTNM stage, nodal metastasis, surgical methods, blood transfusion and PCNA are the most significant

    factors influencing prognosis of gastric carcinoma patients after radical operation. 342 中国临床肿瘤学教育专辑 (2007)

    世界范围内胃癌的发病率有所下降，国内其发病率已降至第三位，次于肝癌和肺癌。然而其死亡率

    一直居高不下，处于第二位，仅次于肺癌。根据IARCPress2004 年报道 2002年中国胃癌人数占到全世界

    的 42%以上，因此胃癌严重威胁人们的身体健康并浪费社会资源。研究影响胃癌患者预后的临床病理因

    素以及探寻行之有效的研究方法，是十分迫切和必要的。

    医学分子生物学技术的发展为胃癌的研究提供了许多非常有效的研究工具，其中组织芯片技术尤为

    特别 ......