【作者】 毛建军；

【导师】 朱培谦；

【作者基本信息】 南昌大学 ， 外科学， 2008， 硕士

【摘要】 目的:研究胃癌组织中胰岛素样生长因子-Ⅰ表达与胃癌内淋巴管的关系及其意义;方法:运用R-T PCR的方法检测38例胃癌组织及15例正常胃组织中胰岛素样生长因子-Ⅰ的表达情况,同时运用免疫组化检测其中的淋巴管及其密度;结果:在正常胃黏膜中IGF-Ⅰ/GAPDH基因比值为0.138±0.012;而在胃癌组织中的表达比正常胃黏膜显著增高,IGF-Ⅰ/GAPDH基因比值为0.362±0.036;在高中分化的腺癌中IGF-Ⅰ/GADPH比值为0.351±0.026,低未分化癌中其值为0.425±0.022;在有淋巴转移的胃癌中这个比值为0.418±0.018,而在无淋巴转移的胃癌中为0.327±0.021;在Ⅰ-Ⅱ期的胃癌中为0.310±0.016,而在Ⅲ-Ⅳ期中为0.448±0.028。在不同性别的病例中,男女病例的比值分别为0.388±0.014及0.369±0.016;在不同年龄组中得到的比值分别为< 60岁0.405±0.015及≥60岁0.411±0.017。经统计学分析IGF-Ⅰ表达与胃癌临床分期(r=0.588, P<0.05),淋巴转移(r=0.693,P<0.05)相关,与分化程度呈负相关(r=-0.462, P<0.05);但与患者性别、年龄无关,均无统计学意义,P〉0.05。胃癌组织淋巴管密度平均9.52±0.54个,正常组织淋巴管密度平均4.29±0.66个;在高中分化的腺癌中LVD为7.52±0.21,低未分化癌中其值为10.81±0.33;在有淋巴转移的胃癌中为12.04±0.52,而在无淋巴转移的胃癌中为8.87±0.60;在Ⅰ-Ⅱ期的胃癌中为6.97±0.51,而在Ⅲ-Ⅳ期中为11.36±0.26。在不同性别的病例中,男女病例的比值分别为9.38±0.36及8.87±0.48;在不同年龄组中得到的比值分别为< 60岁10.56±0.45及≥60岁9.35±0.38;淋巴管密度与淋巴结转移(r=0.525, P<0.05),临床分期(r=0.683, P<0.05)表达相关,与分化程度负相关(r=-0.556, P<0.05),与IGF-Ⅰ的表达成显著正相关(r=0.732,P<0.001);与正常胃组织有显著差异,P<0.001;与性别、年龄无关,不具有统计学意义,P〉0.05。结论:胃癌组织IGF-Ⅰ表达及淋巴管密度与胃癌分化程相关,与胃癌淋巴转移相关,与性别、年龄无关;IGF-Ⅰ与肿瘤淋巴管密度正相关;IGF-Ⅰ可能增加LVD加速肿瘤的淋巴转移。更多还原

【Abstract】 Objective:To explore the relationship between the expression of IGF-Ⅰand LVD in gastric carcinoma .Methods:S - P immunohistochemical method and R-T PCR was applied in detecting carcinoma samples of 38 cases.Results:The mRNA levels of IGF-Ⅰwere increased in gastric cancer tissues compared with normal tissues from healthy controls ,P<0.001. The ratios of IGF-1/GADPH were 0.362±0.036 in gastric cancer tissues,but the ratios were 0.138±0.012 in the tumor free tissues. There was a significant difference of the levels of IGF-Ⅰbetween the group of TNMⅠ+Ⅱ(0.310±0.016)andⅢ+Ⅳ(0.448±0.028) P<0.05);The mRNA levels of IGF-Ⅰin metastatic lymph nodes were higher ( 0.418±0.018 ) than in without metastatic lymph nodes(0.327±0.021).The mRNA levels of IGF-Ⅰin low differentiation were higher (0.425±0.022)than middle-high differentiation(0.351±0.026).The expression of IGF-Ⅰwas positivily correlated with clinical stage(r=0.588, P<0.05),and lympha node metastasis(r=0.693, P<0.05),but was negatively correlated with pathologic differentiation(r=-0.462, P<0.05).The ratios of LVD were 9.52±0.54 in gastric cancer tissues,but the ratios were 4.29±0.66 in the tumor free tissues. There was a significant difference of the levels of IGF-Ⅰbetween the group of TNMⅠ+Ⅱ(6.97±0.51)andⅢ+Ⅳ(11.36±0.26) P<0.05);The LVD in metastatic lymph nodes were higher (12.04±0.52)than in without metastatic lymph nodes(8.87±0.60).The LVD in low differentiation were higher (10.81±0.33)than middle-high differentiation(7.52±0.21).The expression of LVD was positivily correlated with clinical stage(r=0.683, P<0.05),lympha node metastasis(r=0.525, P<0.05,and IGF-Ⅰ(r=0.732,P<0.001),but was negatively correlated with pathologic differentiation(r=-0.556, P<0.05).The expression of IGF-Ⅰwas positivily correlated with LVD(r=0.732, P<0.01)Conclusion:in gastric cancer, the expression rate of IGF-Ⅰand LVD was high. IGF-Ⅰexpression was positively correrated with LVD,and lympha node metastasis.It is presumed that IGF-Ⅰcan promote the metastasis of lyphma node in tumor by inducing LVD expression and the detection of IGF-Ⅰin gastic cancer tissues will be significance for prediction of progonsis更多还原