【作者】 刘湘国；

【导师】 廖国庆；

【作者基本信息】 中南大学 ， 外科学， 2008， 硕士

【摘要】 目的:探讨胃肠道间质瘤(GIST)中E-cadherin和MMP-9表达的意义,以及包括E-cadherin和MMP-9在内的多种因素对GIST预后的影响。方法:回顾分析2002年4月至2006年6月,湘雅医院78例GIST手术病人的临床和病理资料,并进行随访。参考Flecher等关于GIST的恶性潜能分级方法,应用免疫组化S-P法检测各组中E-cadherin和MMP-9的表达情况,分析临床特征、病理分级、E-cadherin和MMP-9的表达等多种因素对GIST术后2年复发转移率和5年生存率的影响。结果:全组病人E-cadherin的阳性表达率为65.4%(51/78),MMP-9的阳性表达率为55.1%(43/78)。E-cadherin和MMP-9的表达在不同的性别年龄组无显著差异(P＞0.05),在高危组与其他组的比较中有显著差异(P＜0.05),列联系数C=0.908。全组病例2年复发转移率和5年生存率分别为31.8%、72.3%。单因素分析不同性别年龄组的2年复发转移率和5年生存率无显著差异(P＞0.05),肿瘤的原发部位、直径大小、核分裂相、E-cadherin和MMP-9的表达对肿瘤的预后影响显著(P＜0.05)。多因素分析显示,不同E-cadherin的表达对GIST的预后影响有显著性(P＜0.05)。结论:E-cadherin及MMP-9在胃肠道间质瘤中均有表达,可能与GIST的生物学行为密切相关,在这个过程中,它们之间的作用成负相关。肿瘤的原发部位、大小、核分裂相、E-cadherin及MMP-9的表达情况与肿瘤的预后密切相关,E-cadherin的表达情况是独立预后因素。E-cadherin可望作为预测术后转移复发的指标,同时纳入肿瘤大小,核分裂相的Flecher恶性潜能分级方法结合E-cadherin和MMP-9的表达情况可能是评估GIST预后的更加准确合理的方法。更多还原

【Abstract】 Objective:To investigate the relationship between the expression of E-cadherin,matrix metalloproteinases 9,and the prognosis of gastrointestinal stromal tumor(GIST).Methods:The clinical and pathological data of 78 patients with GISTs admitted between April 2002 and June 2006 in Xiangya Hospital were analyzed.To refer to Flecher’s classification in GISTs, immunohistochemical technique was used to investigate the expression of E-cadherin and MMP-9.To investigate the impacts of clinical feature,pathologic classification,expression of E-cadherin and MMP-9 on the 2-year recurrence and metastasis rate and 5-year survival rate in patients with GISTs.Results:The positive rate of E-cadherin were 65.4%(51/78)and the positive rate of MMP-9 were 55.1%(43/78)The expression of E-cadherin and MMP-9 had no significant difference in gender,age (P＞0.05),but had significant difference in localization of tumor and the histological grade(P＜0.05).There was negative correlation between the expression of E-cadherin and MMP-9(C=0.908).The 2-year recurrence and metastasis rate and 5-year survival rate were 31.8%,72.3% respectively.No significiant differences in gender and age were existed. Primary organ,Tumor size,mitotic rate and expression of E-cadherin, MMP-9 were analysized respectively.The differences were significiant (P＜0.05).There were significiant differences in expression of E-cad in multiple factors analysis.Conclusion:The expression of E-cadherin and MMP-9 are closely related to the biological behavior of GIST,which may be used as an objective parameter for distinguishing malignant from benign GIST. Primary organ,tumor size,mitotic rate and expression of E-cadherin,MMP-9 are important prognostic factors in GIST,and the expression of E-eadherin is independent prognostic factor.E-cadherin may be an indicator to forecast the recurrence and metastasis rate of GIST. To combine Fleeher’s classification and the expression of E-cadherin, MMP-9 may be a more ratinal,scientific method in GIST’s prognostic analysis.更多还原