Clinical significance of expression of proliferating cell nuclear antigen and E-cadherin in gastric carcinoma.
Clinical significance of expression of proliferating cell nuclear antigen and E-cadherin in gastric carcinoma.
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胃癌中增殖细胞核抗原和E-钙粘蛋白表达的临床意义
DOI：
10.3748/wjg.v23.i20.3721
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发表时间：
2017-05-28
影响因子：
4.3
通讯作者：
Xin L
中科院分区：
文献类型：
--
作者：
Hu L;Li HL;Li WF;Chen JM;Yang JT;Gu JJ;Xin L
目的探讨增殖细胞核抗原(PCNA)和E-钙粘蛋白在胃癌组织中的表达并分析其临床意义。方法 共纳入146例患者，其中肠化生患者38例，异型增生患者42例，原发性胃癌患者66例。另选取40例正常胃组织患者作为对照。免疫组化法检测PCNA、E-cadherin的表达。比较正常胃黏膜、肠化生、不典型增生、胃癌间PCNA和E-cadherin标记指标的差异。具有正常胃组织的受试者被分配到正常组，而胃癌患者被分配到胃癌组。比较两组间PCNA和E-cadherin表达的差异。还探讨了胃癌患者中 PCNA 和 E-钙粘蛋白的表达与临床病理特征之间的关系。此外，还分析了胃癌患者的预后相关因素以及PCNA和E-钙粘蛋白的表达，以确定这些患者的3年生存率。结果 正常胃黏膜、肠化生、不典型增生、胃癌间PCNA、E-cadherin标记指标差异有统计学意义（P < 0.05）。正常胃黏膜向胃癌转变过程中，PCNA标记指数逐渐升高，而E-cadherin标记指数逐渐降低（P < 0.05）。胃癌组PCNA标记指数显着高于不典型增生组，E-cadherin标记指数显着低于不典型增生组（P < 0.05）。胃癌组 PCNA 表达显着高于正常组，但 E-cadherin 表达较正常组弱（P < 0.05）。胃癌组织中PCNA与E-cadherin的表达呈负相关(r=-0.741,P=0.000)。 PCNA表达在有淋巴结转移和无淋巴结转移的胃癌患者以及不同T分期患者之间存在显着差异。有淋巴结转移和无淋巴结转移的胃癌患者中 E-cadherin 表达也存在显着差异（P < 0.05）。高T分期和PCNA阳性表达是胃癌患者预后的危险因素（RR>1），而E-cadherin阳性表达是胃癌患者预后的保护因素（RR<1）。 PCNA阳性预测胃癌患者3年生存的敏感性、特异性和准确性分别为93.33%、38.89%和0.64；而 E-钙粘蛋白阴性的这些值分别为 80.0%、41.67% 和 0.59。当 PCNA 阳性和 E-cadherin 阴性结合时，敏感性、特异性和准确性分别为 66.67%、66.67% 和 0.67。结论PCNA与E-cadherin联合检测可提高评估胃癌患者预后的准确性。
AIM to investigate the expression of proliferating cell nuclear antigen (PCNA) and E-cadherin in gastric carcinoma and to analyze their clinical significance. METHODS A total of 146 patients were selected for this study, including 38 patients with intestinal metaplasia, 42 with dysplasia, and 66 with primary gastric cancer. In addition, 40 patients with normal gastric tissues were selected as controls. The expression of PCNA and E-cadherin was detected by immunohistochemistry. Differences in PCNA and the E-cadherin labeling indexes among normal gastric mucosa, intestinal metaplasia, dysplasia, and gastric carcinoma were compared. Subjects with normal gastric tissues were assigned to a normal group, while gastric cancer patients were assigned to a gastric cancer group. The difference in PCNA and E-cadherin expression between these two groups was compared. The relationship between expression of PCNA and E-cadherin and clinicopathological features was also explored in gastric cancer patients. Furthermore, prognosis-related factors, as well as the expression of PCNA and E-cadherin, were analyzed in patients with gastric cancer to determine the 3-year survival of these patients. RESULTS The difference in PCNA and the E-cadherin labeling indexes among normal gastric mucosa, intestinal metaplasia, dysplasia, and gastric carcinoma was statistically significant (P < 0.05). During the transition of normal gastric mucosa to gastric cancer, the PCNA labeling index gradually increased, while the E-cadherin labeling index gradually decreased (P < 0.05). The PCNA labeling index was significantly higher and the E-cadherin labeling index was significantly lower in gastric cancer than in dysplasia (P < 0.05). The expression of PCNA was significantly higher in the gastric cancer group than in the normal group, but E-cadherin was weaker (P < 0.05). There was a negative correlation between the expression of PCNA and E-cadherin in gastric carcinoma (r = -0.741, P = 0.000). PCNA expression differed significantly between gastric cancer patients with and without lymph node metastasis and between patients at different T stages. E-cadherin expression also differed significantly between gastric cancer patients with and without lymph node metastasis (P < 0.05). High T stage and positive PCNA expression were risk factors for the prognosis of patients with gastric cancer (RR > 1), while the positive expression of E-cadherin was a protective factor (RR < 1). The sensitivity, specificity, and accuracy of PCNA positivity in predicting the 3-year survival of patients with gastric cancer were 93.33%, 38.89%, and 0.64, respectively; while these values for E-cadherin negativity were 80.0%, 41.67%, and 0.59, respectively. When PCNA positivity and E-cadherin negativity were combined, the sensitivity, specificity, and accuracy were 66.67%, 66.67%, and 0.67, respectively. CONCLUSION Combined detection of PCNA and E-cadherin can improve the accuracy of assessing the prognosis of patients with gastric cancer.
DOI：
10.4103/1947-2714.159338
发表时间：
2015-06
期刊：
North American journal of medical sciences
影响因子：
--
作者：
Abreu Velez AM;Howard MS;Kim J;Googe PB
通讯作者：
Googe PB